Use cases in Dermatology

Why use patient-reported outcomes in dermatology?

Dermatology is a specialty where measuring the severity and progression of conditions is seldom easy. There are few if any laboratory values to go by and the visible extent of disease often fails to correlate with its impact on a patient’s life. Patient-reported outcomes make it possible to measure the physical, psychological and functional impact of a skin condition systematically and between clinic visits.

What measures are available?

There are a variety of measures available in dermatology, some of which assess general quality of life and some that are condition specific. Perhaps the most recognized measures are the Skindex-29, the Skindex-16 and the Dermatology Life Quality Index (DLQI). Condition specific measures include the Psoriasis Symptom Assessment (PSA) and the Psoriasis Disability Index (PDI), the Patient Oriented Eczema Measure (POEM) and the Acne Symptoms and Impact Scale (ASIS). Organizations such as the International Dermatology Outcome Measures (IDEOM) are working to develop and validate new measures in psoriasis and other dermatological condition.

How to start a program in your practice

Getting started is easy and we’d encourage you to register on the platform and start testing it with a few of your patients to gain familiarity. In order to stand up a comprehensive outcomes program we recommend a few key steps that we summarized in a short infographic that can be downloaded here.

Illustrative Use Case: Atopic Dermatitis

Atopic dermatitis can be a chronic and debilitating illness, both physically and mentally. A forward thinking dermatology clinic decided to start tracking patient-reported outcomes between clinic visits. They chose to use the Skindex-16 measure at monthly intervals. Patients were recruited in the clinic and given a leaflet about the program and how the data would be used to better understand the nature of their condition and personalize treatment. Clinicians and the practice manager used the platform to identify patients who are on a downward trend and who would benefit from additional outreach. When these patients came in to the clinic, historic trends were viewed to help guide the consultation, focus attention on areas of need and understand the efficacy of past treatments. Through this program they’ve been able to boost patient satisfaction, attract & retain new patients and provide demonstrably better care.

Illustrative Use Case: Psoriasis

Severe psoriasis is increasingly recognized as having important physical and psychosocial effects that extend beyond the skin. The arrival of biologic treatments has brought more options to those with severe disease, however with potentially serious side-effects and treatment costing up to $30,000 per year, the need to monitor efficacy has never been greater. A dermatology clinic that wanted to keep a closer eye on these patients chose bi-weekly check-ins using the Dermatology Quality of Life Index (DQLI) delivered in the comfort of the patient’s home. With the patient-reported data flowing back to the clinic, they were able to better identify primary and secondary treatment failure and proactively manage their patient’s care.

Illustrative Use Case: Roseacea

Studies have shown that there is little or no correlation between objective dermatologist assessment of roseacea (based on photos) and the patient’s own subjective assessment of severity and impact on quality-of-life. A practice decided to incorporate patient-reported assessments in to their decision-making process for this often hard to treat condition. Using the Skindex-16, they survey patients before and between visits and use the information that comes back to guide conversations around treatment options, to focus in on particular areas of patient concern and to assess the efficacy of treatments over time.

The Research

Some important papers in the space

See it in action

Watch a screencast example of a dermatology practice using our platform to manage their patients.