Effectiveness of programmes focused on disease care or clinics of excellence versus conventional care programmes in treating psoriasis and psoriatic arthritis. A systematic review of the literature

Abstract

IntroductionPsoriasis (PsO) and psoriatic arthritis (PsA) are chronic rheumatic diseases with a significant impact on quality of life. Consensus has been described in the literature to determine the preliminary points for implementing a centralized patient care programme. However, there is no clarity regarding its effectiveness in real-life conditions. ObjectiveTo collect the evidence systematically and exhaustively that meets the search and eligibility criteria for effectiveness of centralized care programmes in the population diagnosed with PsO and PsA. Materials and methodsA systematic review of the literature was carried out over 5 years using the electronic bases Medline, PubMed, Cochrane, Virtual Health Library, and Embase of models focused on disease care or clinics of excellence versus programmes of conventional care. ResultsA total of 8902 articles were identified, of which 16 studies were selected and grouped into 3 domains: multidisciplinary care, telemedicine, and training by health professional, and patient self-management, determining the programmes’ effectiveness through scales such as PASI, DAPSA, DAS28, EQ-5D-5L, DLQI, SF36, and MMAS-8, as well as adherence to medication, satisfaction levels, improvement perception, comorbidities assessment, and early diagnosis of joint involvement. DiscussionThe clinical evidence that supports the effectiveness of centralized patient care programme strategies is scarce. However, the information collected demonstrates the efficacy of these interventions using activity and quality of life outcomes, demonstrating the importance of their use and implementation in PsO and PsA care.