Psychosocial well‐being of patients with skin diseases in general practice

Verhoeven, E.W.M.; Kraaimaat, F.W.; Kerkhof, P.C.M. van de; Weel, Chris van; Duller, P.; Valk, P.G.M. van der; Hoogen, H.J.M. van den; Bor, J.H.J.; Schers, Henk; Evers, Andrea W M

doi:10.1111/j.1468-3083.2007.02049.x

Cited by 29 publications

(34 citation statements)

References 36 publications

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“…Itch and related seratehing problems constitute a major problem in patients with AD (1)(2)(3)(4)(5)(6)(7)(8). On the basis of multidiseiplinary itch treatment schemes (9)(10)(11)(12)(13), in the present study we examined the short-and longerterm effectiveness of a brief, multidiseiplinary group The results showed the training programme to be effective in comparison with a waiting list control condition.…”

Section: Discussionmentioning

confidence: 88%

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Effectiveness of a Multidisciplinary Itch-coping Training Programme in Adults with Atopic Dermatitis

Evers¹,

Duller²,

Jong³

et al. 2009

Acta Derm Venerol

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The short- and longer-term effectiveness of a brief, multidisciplinary itch-coping group training scheme in adults with atopic dermatitis was evaluated. Clinical severity scores (Eczema Area and Severity Index) and validated self-report measures were obtained in a waiting-list control condition (n=30) and a treatment condition (n=61) at pre- and post-treatment and in the treatment condition at 3- and 12-month follow-ups. Relative to the control condition, all post-treatment measures showed improvements in terms of enhanced skin status, reduced itching and scratching and improved itch-coping patterns. In the treatment condition, the changes were sustained or further improved at both follow-ups. Also, the dermatological healthcare use was significantly reduced during the follow-up periods, in terms of fewer visits to the dermatologist and decreased use of topical corticosteroids and itch-relieving medication (histamine antagonists). The brief multidisciplinary itch-coping programme in adults with atopic dermatitis considerably reduced itch-scratching patterns, improved their skin status and reduced the use of dermatological care, both in the short and longer term.

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Section: Discussionmentioning

confidence: 88%

“…Chronic itch is the main symptom of atopic dermatitis (AD) (1)(2)(3)(4)(5)(6)(7)(8). As an adjunct to standard dermatological care, multidisciplinary itch-coping programmes have been developed (9-12; see 13 for a review).…”

mentioning

confidence: 99%

Effectiveness of a Multidisciplinary Itch-coping Training Programme in Adults with Atopic Dermatitis

Evers¹,

Duller²,

Jong³

et al. 2009

Acta Derm Venerol

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“…The physical and psychosocial burden for patients with skin diseases is comparable to patients with other chronic diseases, like multiple sclerosis and migraine, and even higher than patients with diabetes mellitus. In 18% of the patients symptoms of a clinical depression is present [5]. Medical consumption is also high; 60% visit their general practitioner in a year and 20% visit a medical specialist.…”

Section: Introductionmentioning

confidence: 99%

Integrated, multidisciplinary care for hand eczema: design of a randomized controlled trial and cost-effectiveness study

et al. 2009

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BackgroundThe individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity loss and sick leave. Usual care is suboptimal, due to a lack of optimal instruction and coordination of care, and communication with the general practitioner/occupational physician and people involved at the workplace. Therefore, an integrated, multidisciplinary intervention involving a dermatologist, a care manager, a specialized nurse and a clinical occupational physician was developed. This paper describes the design of a study to investigate the effectiveness and cost-effectiveness of integrated care for hand eczema by a multidisciplinary team, coordinated by a care manager, consisting of instruction on avoiding relevant contact factors, both in the occupational and in the private environment, optimal skin care and treatment, compared to usual, dermatologist-led care.MethodsThe study is a multicentre, randomized, controlled trial with an economic evaluation alongside. The study population consists of patients with chronic, moderate to severe hand eczema, who visit an outpatient clinic of one of the participating 5 (three university and two general) hospitals. Integrated, multidisciplinary care, coordinated by a care manager, including allergo-dermatological evaluation by a dermatologist, occupational intervention by a clinical occupational physician, and counselling by a specialized nurse on optimizing topical treatment and skin care will be compared with usual care by a dermatologist. The primary outcome measure is the cumulative difference in reduction of the clinical severity score HECSI between the groups. Secondary outcome measures are the patient's global assessment, specific quality of life with regard to the hands, generic quality of life, sick leave and patient satisfaction. An economic evaluation will be conducted alongside the RCT. Direct and indirect costs will be measured. Outcome measures will be assessed at baseline and after 4, 12, 26 and 52 weeks. All statistical analyses will be performed on the intention-to-treat principle. In addition, per protocol analyses will be carried out.DiscussionTo improve societal participation of patients with moderate to severe hand eczema, an integrated care intervention was developed involving both person-related and environmental factors. Such integrated care is expected to improve the patients' clinical signs, quality of life and to reduce sick leave and medical costs. Results will become available in 2011.

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“…Patients report decreased psychological well-being and lower quality of life compared to the general population [3,6,7]. For 20 to 40 percent of this group, symptoms are so severe that they are considered a risk group for long-term adjustment problems which require further treatment [4]. The decreased psychosocial well-being can in turn negatively affect the skin condition; for example, patients with psoriasis who also have a high level of psychological distress benefit less from treatments such as phototherapy [8].…”

Section: Prevalent Problems In Patients With Dermatological Conditionsmentioning

confidence: 99%

Psychological Treatments for Dermatological Conditions

2016

Skin and Psyche

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Abstract:The impact of dermatological conditions on a patient's life is frequently underestimated. Patients with skin conditions experience several physical complaints, including itch, pain and fatigue. Furthermore, in comparison to the general population, patients report a decreased psychological well-being, lowered quality of life and feelings of stigmatization and shame. Psychological treatments are widely used in addition to regular dermatological treatments to improve physical and psychological functioning of patients with chronic skin conditions. These treatments are usually aimed at changing the psychosocial factors that can influence the onset and/or course of skin conditions, such as dysfunctional coping behaviors, itch-scratching problems and stress. There are unimodal interventions in which single treatments are used, for example psychoeducation or relaxation exercises, and multimodal treatments in which a variety of different interventions are applied based on cognitive-behavioral therapy and self-management principles. Furthermore, a distinction can be made between interventions that focus primarily on skin-related psychosocial problems, interventions that focus on itch-scratching problems, and interventions that are focused on psychiatric problems in the dermatological practice. This chapter gives an overview on the psychosocial factors relevant for dermatological conditions, relevant diagnostic methods and the content and scientific evidence of specific psychological treatments in these different categories.

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Psychosocial well‐being of patients with skin diseases in general practice

Cited by 29 publications

References 36 publications

Effectiveness of a Multidisciplinary Itch-coping Training Programme in Adults with Atopic Dermatitis

Effectiveness of a Multidisciplinary Itch-coping Training Programme in Adults with Atopic Dermatitis

Integrated, multidisciplinary care for hand eczema: design of a randomized controlled trial and cost-effectiveness study

Psychological Treatments for Dermatological Conditions

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