A Reply to ‘Comment on “The Doctors' Perception of Skin Diseases in General Practice in Denmark, With Emphasis on Atopic Dermatitis—A Descriptive Study”—The Irish Experience’ by Wolinska et al. Dermatology Training in General Practice—A Pan-European Challenge?
A. S. Frølunde, M. Deleuran, J. L. Thomsen, C. Vestergaard
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引用次数: 0
Abstract
We read the letter from Wolinska et al. with great interest and thank them for their insightful comment. The letter emphasizes the need for enhanced dermatological training for general practitioners (GPs), a necessity highlighted in our study and supported by findings across the literature [1-3]. The critical question is how best to implement this training: Should it involve online modules, in-person courses, clinical rotations in dermatology departments, expanded medical school curricula or other methods? Addressing this need effectively invites international collaboration among countries with healthcare systems in which GPs act as gatekeepers, encountering a high volume of patients with skin symptoms and diseases. Such collaboration can help develop the most effective and practical educational strategies.
In reference to Wolinska et al.'s study, a noteworthy point is raised regarding confidence in diagnosing atopic dermatitis in patients with skin of colour (SoC) [2]. Only 29% of respondents felt confident diagnosing atopic dermatitis in patients with SoC. Although awareness of SoC in dermatology has increased in recent years, the imagery in educational resources still primarily features patients with Fitzpatrick skin types II and III [4, 5]. It is unsurprising, then, that studies assessing diagnostic confidence among both dermatologists and non-dermatologists reflect similar gaps, underlining that this is an area in need of significant knowledge improvement.
In summary, the findings from both studies highlight an urgent need for targeted training initiatives for GPs. Given that dermatologists have managed fewer than 30% of patient visits for skin-related issues in the United States during periods of workforce shortages, there is a significant reliance on non-dermatologist care [6]. This demand will likely intensify as the population ages and the incidence of skin cancer rises, further increasing the need for effective dermatological care [7]. Consequently, these findings emphasize the importance of developing targeted training programs that equip healthcare providers to meet the evolving dermatological needs of their patients with confidence.
Anne Sofie Frølunde drafted the manuscript and finalized it based on input from the co-authors. Mette Deleuran, Janus Laust Thomsen and Christian Vestergaard critically revised the draft. All authors have read and approved the final version of the manuscript.
Not applicable.
M.D. has received research support, honoraria for lecturing and/or consulting/advisory board agreements from AbbVie, Eli Lilly, LEO Pharma, UNION Therapeutics, Incyte, La Roche Posay, NUMAB Therapeutics AG, Pierre Fabre, Pfizer, Regeneron Pharmaceuticals Inc., Sanofi Genzyme, Almirall and Kymab. None of these COIs are relevant to the present article. C.V. has acted as a speaker and/or consultant for Almirall, Sanofi A/S, Eli Lilly Denmark A/S, Novartis Healthcare A/S, Janssen-Cilag A/S, LEO Pharma A/S, AstraZeneca A/S, Eli Lilly & Co Ltd, Pierre Fabre, Chiesi, Galderma, Pfizer and Abbvie, and has received research grants from Sanofi, Pfizer and Almirall. The other authors declare no conflicts of interest.
我们怀着极大的兴趣阅读了Wolinska等人的来信,并感谢他们富有见地的评论。该信强调需要加强全科医生(gp)的皮肤病学培训,这是我们研究中强调的必要性,并得到了文献研究结果的支持[1-3]。关键的问题是如何最好地实施这种培训:它应该包括在线模块、面对面的课程、皮肤科的临床轮转、扩展的医学院课程还是其他方法?有效地解决这一需求需要拥有医疗保健系统的国家之间的国际合作,在这些系统中,全科医生充当看门人,遇到大量患有皮肤症状和疾病的患者。这种合作有助于制定最有效和最实用的教育战略。参考Wolinska等人的研究,提出了一个值得注意的观点,即对有色皮肤(SoC)患者诊断特应性皮炎的信心[0]。只有29%的受访者对SoC患者的特应性皮炎诊断有信心。尽管近年来皮肤科对SoC的认识有所提高,但教育资源中的图像仍然主要以II型和III型Fitzpatrick皮肤患者为特征[4,5]。因此,毫不奇怪,评估皮肤科医生和非皮肤科医生诊断信心的研究反映出类似的差距,强调这是一个需要重大知识改进的领域。总之,两项研究的结果都强调了对全科医生进行有针对性培训的迫切需要。鉴于在美国,在劳动力短缺期间,皮肤科医生管理的皮肤相关问题患者不到30%,因此对非皮肤科医生的护理有很大的依赖。随着人口老龄化和皮肤癌发病率的上升,这种需求可能会加剧,进一步增加对有效皮肤病学护理的需求。因此,这些发现强调了发展有针对性的培训计划的重要性,使医疗保健提供者有信心满足患者不断变化的皮肤病学需求。Anne Sofie Frølunde根据共同作者的意见起草并定稿。Mette Deleuran, Janus Laust Thomsen和Christian vestergard对草案进行了严格的修改。所有作者都阅读并认可了稿件的最终版本。不是applicable.M.D。获得了AbbVie、Eli Lilly、LEO Pharma、UNION Therapeutics、Incyte、La Roche Posay、NUMAB Therapeutics AG、Pierre Fabre、Pfizer、Regeneron Pharmaceuticals Inc.、Sanofi Genzyme、Almirall和Kymab的研究支持、讲学荣誉和/或咨询/顾问委员会协议。这些coi都与本文无关。C.V.曾担任Almirall, Sanofi a /S, Eli Lilly Denmark a /S, Novartis Healthcare a /S, Janssen-Cilag a /S, LEO Pharma a /S, AstraZeneca a /S, Eli Lilly &;此外,辉瑞、赛诺菲、辉瑞和Almirall也为其提供了研究资助。其他作者声明没有利益冲突。