Current application of National Institute for Health and Clinical Excellence (NICE) guidance in the management of patients with severe psoriasis: a clinical audit against NICE guidance in seven National Health Service specialist dermatology units in Engla

Abstract

In the seven sites audited, compliance with national guidance was entirely appropriate in terms of therapy initiation; however, the requirement to discontinue etanercept in responders was rarely followed. Similarly, discontinuation of biologicals in nonresponders was not routine practice. This may indicate a reluctance of both patients and clinicians to withdraw an at least partly effective therapy from these refractory patients.

A national study on adherence to a basal cell carcinoma guideline; development of a tool to assess guideline adherence

“…Previous audits to evaluate the use of dermatological guidelines were mostly focused on a specific part of a guideline and/or assessed the implementation in one centre . Other audits invited and included only interested dermatologists to participate and/or relied on self‐reporting questionnaires . This study analyses and discusses the adherence to all recommendations in a basal cell carcinoma (BCC) guideline, using a method that obtains daily practice feedback on a nationwide level.…”

“…21,22 Other audits invited and included only interested dermatologists to participate and/or relied on self-reporting questionnaires. [23][24][25][26] This study analyses and discusses the adherence to all recommendations in a basal cell carcinoma (BCC) guideline, using a method that obtains daily practice feedback on a nationwide level.…”

Treatment patterns and therapy effectiveness in psoriasis patients initiating biologic therapy in England

“…Additionally, only 21% of patients who were persistent on their biologic therapy for 12 months had total clearance of their psoriasis. With 36% of patients experiencing a change in their biologic therapy within the first 12 months after initiation and the limited response to current biologic agents that were observed in this present study as well as in other studies (13,(20)(21)(22), there is a need to raise the awareness among dermatologists and healthcare providers that alternative therapies are needed. New effective and safe therapies are needed to reduce the need for therapy changes among patients with severe psoriasis.…”

“…However, it was noted that 30% of patients who initiated biologic therapy required combination therapy with traditional systemic agents either at initiation or to counter loss of effect while on biologic therapy. Additionally, a study in seven specialist dermatology units in the UK found that 40% of patients with psoriasis were continued on biologic treatment despite not achieving adequate response according to NICE criteria (22). Other European and U. S. studies have found that response to current biologic therapy is lower in clinical practice than in randomized controlled trials (13,23).…”

Dermatosurgery: Total Quality Management in a Dermatology Department

“…In contrast, several clinical audits focusing on therapeutic practices or medical services were previously published in dermatology [14,15,16]. The methodology of our audit was original, with the involvement of 2 external auditors and multiple analysis criteria, and exceeded the usual clinical audit requirements.…”