Initiating value‐based healthcare in psoriasis: Proposing a value‐based outcome set for daily clinical practice

Hilhorst, Niels; Deprez, Elfie; Balak, Deepak M W; Geel, Nanja van; Gutermuth, J; Hoorens, Isabelle; Lambert, Jo

doi:10.1111/jdv.18696

Cited by 6 publications

(16 citation statements)

References 37 publications

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“…Therefore, there was also no set of outcomes available that grasped the overall value healthcare professionals created in daily clinical practice. In previous work, we have defined which outcomes matter to psoriasis patients and proposed a value-based outcome set (VOS), which can be used to direct psoriasis care in a value-based manner 14 15…”

Section: Introductionmentioning

confidence: 99%

Value in psoriasis (IRIS) trial: implementing value-based healthcare in psoriasis management – a 1-year prospective clinical study to evaluate feasibility and value creation

et al. 2023

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IntroductionCurrently, the healthcare sector is under tremendous financial pressure, and many acknowledge that a dramatic shift is required as the current system is not sustainable. Furthermore, the quality of care that is delivered varies strongly. Several solutions have been proposed of which the conceptual framework known as value-based healthcare (VBHC) is further explored in this study for psoriasis. Psoriasis is a chronic inflammatory skin disease, which is associated with a high disease burden and high treatment costs. The objective of this study is to investigate the feasibility of using the VBHC framework for the management of psoriasis.Methods and analysisThis is a prospective clinical study in which new patients attending the psoriasis clinic (PsoPlus) of the Ghent University Hospital will be followed up during a period of 1 year. The main outcome is to determine the value created for psoriasis patients. The created value will be considered as a reflection of the evolution of the value score (ie, the weighted outputs (outcomes) divided by weighted inputs (costs)) obtained using data envelopment analysis. Secondary outcomes are related to comorbidity control, outcome evolution and treatment costs. In addition, a bundled payment scheme will be determined as well as potential improvements in the treatment process. A total of 350 patients will be included in this trial and the study initiation is foreseen on 1 March 2023.Ethics and disseminationThis study has been approved by the Ethics Committee of the Ghent University Hospital. The findings of this study will be disseminated by various means: (1) publication in one or more peer-reviewed dermatology and/or management journals, (2) (inter)national congresses, (3) via the psoriasis patient community and (4) through the research team’s social media channels.Trial registration numberNCT05480917.

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Section: Introductionmentioning

confidence: 99%

Value in psoriasis (IRIS) trial: implementing value-based healthcare in psoriasis management – a 1-year prospective clinical study to evaluate feasibility and value creation

et al. 2023

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“…In previous work, we have defined a value-based outcome set (VOS) which can be used to document and capture the value healthcare professionals (HCPs) create in daily clinical practice [10]. This outcome set encompasses patient-reported outcomes (PROs) as well as clinician-reported outcomes.…”

Section: Applying Vbhc To Psoriasis Managementmentioning

confidence: 99%

PsoPlus: An Integrated Practice Unit for Psoriasis

et al. 2023

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There is a need to revise current healthcare organization due to the ever-rising costs and variation in quality of delivered care. Over the past decades there have been several strategic frameworks attempting to tackle this problem. Value-based healthcare (VBHC) is one those frameworks which has gained increasing popularity the last years. The framework is formulated on the premise that the healthcare sector should deliver integrated care, using integrated practice units (IPUs), and strive to maximize the value created. Value in this context is defined as the health outcomes achieved per costs made. We have designed a lean IPU called PsoPlus in which psoriasis patients are managed by a multidisciplinary team which has all the expertise and skill to manage psoriasis and its associated conditions. In addition, we have developed and implemented guidelines for the management of psoriasis associated comorbidities enabling us to deliver integrated care in the Belgian healthcare setting. Finally, we have designed a supporting information technology platform, called PsoSmart, that brings data from patients and healthcare providers together and provides actionable insights for clinical decision making. The created value is documented and captured using a value-based outcome set. Cost assessments at the individual patient level are also performed. To conclude, we describe here a comprehensive IPU setting for psoriasis which incorporates the VBHC principles. This IPU goes further and delivers a higher level of integrated care than other multidisciplinary psoriasis clinics. Monitoring outcomes and costs provides us with further insights to optimize psoriasis care. In addition, a software program designed to enhance psoriasis care is being developed further, however, advances in healthcare technology are needed.

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“…The methodology and results of the ranking exercise as well as a detailed description of the population were previously described. 7 In short, a mixed method approach was used consisting of a systematic review, a nominal group technique and a ranking exercise with cards. A systematic review was conducted, providing an overview of all patient-relevant outcomes defined in current literature.…”

Section: Me Thodologymentioning

confidence: 99%

“…This was extensively reviewed by our group as we conducted a systematic review which analysed patient-relevant outcomes in psoriasis and subsequently performed a ranking exercise in a cohort of psoriasis patients to discover the determinants of true value. 6,7 We found that variables such as for example, age, gender, disease duration and disease severity influenced the importance of several outcomes. 7 Several of these findings were also corroborated by previous studies.…”

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Determining patient value profiles in psoriasis

Hilhorst

Abatih

Deprez

et al. 2023

Experimental Dermatology

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BackgroundHealthcare professionals (HCPs) should strive to create the maximum value for their patients in which value is defined as the patient‐relevant health outcomes achieved per costs made. However, currently it remains difficult to determine which outcomes matter to an individual psoriasis patient.ObjectiveTo define outcome profiles, or so called ‘patient value profiles’, within a cohort of psoriasis patients that can be translated to daily practice to increase value for the individual patient.MethodsHierarchical clustering on principal components (HCPC) was used to identify groups of patients sharing the same profile within an outcome ranking exercise. Once the clusters were defined, their characterization was provided based on a V‐test. In a final step, a multi‐class decision tree (MDT) based on relevant socio‐demographic and clinical variables was built to allocate patients to a cluster.ResultsIn the ranking exercise 120 patients participated. The median age was 50.0 (IQR 25.0) years and 36.7% were female. Median PASI score was 2.4 (IQR 5.2) and median duration of psoriasis was 17.0 (IQR 20.0) years. Primary treatment varied from topicals to biologicals. We found three distinct patient value profiles in this cohort (QoL, cost and treatment). A MDT was built which had an accuracy of 64%.ConclusionWe found three distinct patient value profiles in a cohort of psoriasis patients and patients can be easily assigned to one of these profiles based on a MDT. HCPs can use these profiles to steer psoriasis management accordingly allowing for a more goal‐orientated approach.

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Initiating value‐based healthcare in psoriasis: Proposing a value‐based outcome set for daily clinical practice

Cited by 6 publications

References 37 publications

Value in psoriasis (IRIS) trial: implementing value-based healthcare in psoriasis management – a 1-year prospective clinical study to evaluate feasibility and value creation

Value in psoriasis (IRIS) trial: implementing value-based healthcare in psoriasis management – a 1-year prospective clinical study to evaluate feasibility and value creation

PsoPlus: An Integrated Practice Unit for Psoriasis

Determining patient value profiles in psoriasis

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