How to improve people-centred healthcare in dermatology?

Abstract

People with chronic skin diseases, such as psoriasis, experience multifaceted impairments that include physical symptoms, such as pain, psychological symptoms, such as anxiety, and social impairments, such as stigmatisation. To address this broad spectrum of impairments, a holistic healthcare approach is needed. The World Health Organization has established the people-centred model of care, in which health services adopt the perspective of people affected and their environment. The needs of patients are respected, and patients are put at the centre of care. This model was also adopted by the global report on psoriasis, which aims to improve the wellbeing of the affected people. This paper gives a brief overview of the status quo and an outline of how to improve people-centred care and patient orientation in dermatology, specifically for people with psoriasis. This includes the application of shared decision-making. Although only a few patient decision aids for psoriasis have been published, promising results regarding the reimbursement of shared decision-making applications in the hospital setting by health insurances are available, which also refer to dermatology departments. In addition, the use of patient-reported outcomes is of great importance to give patients a voice in their own healthcare. In accordance with the people-centred model, it is recommended to not only assess patients' perspectives, such as their needs, goals, and treatment benefits, but also the needs and treatment benefits of the patients' environment, such as their partner and treating healthcare professionals. One recent example of such a people-centred approach is the POSITIVE-study, which is the first study assessing the treatment effect on the wellbeing of patients with psoriasis. Moreover, the treatment benefit on physicians' satisfaction and patients' partners' lives is being evaluated. Therefore, it could act as a best practice example of how to integrate a people-centred approach in research.