Jennifer Klotz1, Linda Muir, Crystal Cameron, Laura Delaney. 1. Division of Dermatology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, 4195 Dickson Building, B3H 1V8, Halifax, Nova Scotia, Canada. jennifer.klotz@cdha.nshealth.ca
Abstract
BACKGROUND: The delivery of effective phototherapy to patients with psoriasis living in areas devoid of dermatologists is difficult. Telemedicine has proven useful in the delivery of health care in such locations. OBJECTIVE: This evidence-based study sought to investigate the use of telemedicine in the monitoring of phototherapy of psoriasis patients located in a Nova Scotia region with no dermatologist. METHODS: Psoriatic patients were reviewed six months before and after protocols and monitoring were instituted. First, charts of 23 patient treated with phototherapy were reviewed from the Aberdeen Hospital in New Glasgow. Patients were either self-referred or referred by a family physician and occasionally a dermatologist. Treatments were not monitored by a specialist. Second, a group of 33 patients receiving treatment were supervised via telemedicine by a dermatologist 250 km away in Halifax. RESULTS: During the study period, treatment time decreased from 140 to 37 days. In the monitored group, 40% more patients were clear of psoriasis at time of discharge. The number of patients with side effects decreased. The number of self-and family practice-referred patients dropped; the clinic became a referral center for dermatologists. CONCLUSION: Telemedicine provided an excellent way to monitor patients receiving phototherapy in an area without a dermatologist. Overall, patient care improved: More patients were treated effectively with better outcomes and fewer side effects.
BACKGROUND: The delivery of effective phototherapy to patients with psoriasis living in areas devoid of dermatologists is difficult. Telemedicine has proven useful in the delivery of health care in such locations. OBJECTIVE: This evidence-based study sought to investigate the use of telemedicine in the monitoring of phototherapy of psoriasispatients located in a Nova Scotia region with no dermatologist. METHODS: Psoriatic patients were reviewed six months before and after protocols and monitoring were instituted. First, charts of 23 patient treated with phototherapy were reviewed from the Aberdeen Hospital in New Glasgow. Patients were either self-referred or referred by a family physician and occasionally a dermatologist. Treatments were not monitored by a specialist. Second, a group of 33 patients receiving treatment were supervised via telemedicine by a dermatologist 250 km away in Halifax. RESULTS: During the study period, treatment time decreased from 140 to 37 days. In the monitored group, 40% more patients were clear of psoriasis at time of discharge. The number of patients with side effects decreased. The number of self-and family practice-referred patients dropped; the clinic became a referral center for dermatologists. CONCLUSION: Telemedicine provided an excellent way to monitor patients receiving phototherapy in an area without a dermatologist. Overall, patient care improved: More patients were treated effectively with better outcomes and fewer side effects.