19 research outputs found
Exploring Patients' Insight, Concerns, and Expectations at Dermatology Clinic:An Observational Study in 2 Centers in Scotland and Spain
Background:
Effective doctor–patient communication is of great importance in order to optimize medical consultation outcomes. However, it can be difficult to address all patients’ concerns and expectations in clinic.
Objective:
To identify how much patients know about their medical condition, their fears and concerns, and their expectations, as well as evaluate the benefits of using a preconsultation questionnaire routinely.
Methods:
This study included consecutive patients attending dermatology outpatients from Dundee (Scotland) and Granada (Spain) who completed a simple preconsultation 3-part questionnaire. Answers to this questionnaire were discussed during clinic visits.
Results:
Two hundred patients participated in the study. Of all, 111 (55.5%) patients already knew their diagnosis or were able to describe their symptoms and/or feelings quite accurately at their visit to Dermatology. Most patients (85%) had fears regarding their dermatological problem. A majority of patients (97%) came to clinic with specific expectations, and many (41.5%) had multiple expectations. A high proportion of patients (74%) found the questionnaire useful.
Conclusion:
Patients attend clinic with different levels of knowledge, fears, and expectations. We recommend using a brief and easy to use preconsultation questionnaire as a cost-effective way of enhancing doctor–patient communication
Clinical outcomes and response to treatment of patients receiving topical treatments for pyoderma gangrenosum: a prospective cohort study
Background: pyoderma gangrenosum (PG) is an uncommon dermatosis with a limited evidence base for treatment.
Objective: to estimate the effectiveness of topical therapies in the treatment of PG.
Methods: prospective cohort study of UK secondary care patients with a clinical diagnosis of PG suitable for topical treatment (recruited July 2009 to June 2012). Participants received topical therapy following normal clinical practice (mainly Class I-III topical corticosteroids, tacrolimus 0.03% or 0.1%). Primary outcome: speed of healing at 6 weeks. Secondary outcomes: proportion healed by 6 months; time to healing; global assessment; inflammation; pain; quality-of-life; treatment failure and recurrence.
Results: Sixty-six patients (22 to 85 years) were enrolled. Clobetasol propionate 0.05% was the most commonly prescribed therapy. Overall, 28/66 (43.8%) of ulcers healed by 6 months. Median time-to-healing was 145 days (95% CI: 96 days, ∞). Initial ulcer size was a significant predictor of time-to-healing (hazard ratio 0.94 (0.88;80 1.00); p = 0.043). Four patients (15%) had a recurrence.
Limitations: No randomised comparator
Conclusion: Topical therapy is potentially an effective first-line treatment for PG that avoids possible side effects associated with systemic therapy. It remains unclear whether more severe disease will respond adequately to topical therapy alone