18686 Unmet needs in psoriasis assisted by telementoring

Abstract

Argentina is a large country with huge asymmetries between the access of medical assistance among the different regions. Telemedicine is a big opportunity to reduce disparities in psoriasis care. The Project ECHO (Extension for Community Healthcare Outcomes) is a model of distance medical education, empowering providers who work in remote areas and treat complex medical diseases. It is developed by videoconferencing case presentations between experts and providers. Since 2015 we have implemented this telementoring model for dermatologists who treat patients with psoriasis. The objective of this study was to explore the unmet needs of dermatologists attending psoriatic patients, and how can the experts help them offer better medical practices. Sixty teleclinics were held with 120 dermatologists covering all regions of our country. The median of participants per teleclinic was 23. A total of 213 consultations were performed, 157 were first consultations and the rest follow-up queries. Ninety five percent of the patients had a moderate to severe disease and 20% of them had never received a systemic therapy. The main reasons for consultations were: to define a new treatment (29%), drugs and dose changes (28%), and for reassurance (26%). Therapy modification was proposed by the experts in 60% of the cases. Starting a conventional systemic therapy (33%) and switching biologic agents (43%) were the most frequent suggestions. In one out of 3 cases, the experts’ advice could not be achieved because of different barriers, such as adherence (71%) and access (39%). Telementoring is a useful tool for medical education in psoriasis.