MedicalResearch.com Interview with:
Robert S. Kirsner, MD, PhD, FAAD
Interim Chairman and Harvey Blank Professor in Dermatology, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine
Director, University of Miami Hospital Wound Center
Chief of Dermatology, University of Miami Hospital
Medical Research: What is the background for this study? What are the main findings?
Dr. Kirsner: Psoriasis is common, affecting 7.5 million Americans. The major indication of psoriasis is chronic inflammation of the skin. It is characterized by disfiguring, scaling and erythematous plaques that may be painful or pruritic and may cause significant quality of life issues. Psoriasis may also cause joint pain and more recently has been associated with metabolic syndrome, diabetes, cardiovascular disease, dyslipidemia, hypertension and nonalcoholic fatty liver disease. Thus, patients may be physically and emotionally impacted by psoriasis.
The American Academy of Dermatology (Academy) developed a Performance Improvement (PI) CME activity to enhance dermatologists’ care of psoriasis patients by allowing them to evaluate their practice using patient charts, utilize evidence-based strategies to overcome self-identified gaps, and then re-measure their performance using charts for patients seen after practice changes were implemented.
It was found that the PI CME activity significantly improved dermatologists’ overall documentation of patient history, patient counseling for lifestyle behaviors and shared decision-making ability. For example, dermatologists who participated in and completed this PI CME activity improved practice performance by either inquiring about or documenting to a greater extent comorbidities (particularly cardiovascular disease), drug costs and interactions, patient preference, other medical problems, and severity of disease, resulting in an overall improvement in documented clinical behaviors.
Medical Research: What should clinicians and patients take away from your report?
Dr. Kirsner: This is the first example within dermatology of a PI CME activity changing physicians’ practice. Previously, we only knew that education changed knowledge and application of that knowledge in theoretical situations. Physicians should be aware that it is possible to enhance their practice — and, as a result, their patient care — by using well-designed performance improvement education tools.
The results from this PI CME activity illustrate the potential effectiveness of this approach to quality improvement. Physician time is limited; therefore, educational activities that impact patient care are needed. In an already heavily regulated health care environment, it is important not only to address clinicians’ educational needs, but also provide them with activities that are meaningful to them, have an impact on patient care, and assist them in meeting their MOC and CME credit requirements. The Academy’s PI CME activities are accredited for 20 AMA PRA™ credits.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Kirsner: Since this is the first example within dermatology of a PI CME activity changing physicians’ practice, and it is specifically related to psoriasis, other studies are needed to confirm this finding in other disease areas. The best education tools need to be defined, and we need a better understanding of the most effective means of delivering education to impact physician performance and patient care.
MedicalResearch.com Interview with:, Robert S. Kirsner, MD, PhD, FAAD, & Interim Chairman and Harvey Blank Professor in Dermatology, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine (2015). Performance Improvement CME Improved Psoriasis Care By Dermatologists MedicalResearch.com