The profile of dermatological problems in primary care
ABSTRACT Cutaneous disease is thought to account for 10-15% of patient consultations with general practitioners, but relatively little is known about the demography of dermatological conditions in primary care.
To assess the proportion and diagnostic profile of dermatological conditions seen in primary care in the southeast of Scotland, and to draw comparisons with secondary dermatological care.
General practitioners in 13 general practices were asked to note all skin-related consultations during a 2-week period. The case notes of these patients were reviewed, and diagnosis and treatment was recorded. Patients who had consulted for the same skin disorder on >or= 3 occasions during the previous year were invited for assessment by a consultant dermatologist. Where possible, the case notes from 10% of all consultations during the 2-week study period were examined to assess accuracy of recording.
The percentage of consultations relating to cutaneous disorders varied between practices, ranging from 3% to 18.8%, with a mean of 8.4%. Eczema accounted for 22.5%, infections 20.3% and benign tumours for 11.4% of consultations with a dermatological basis. In contrast, in secondary care, benign tumours accounted for 23.8%, malignant tumours for 16.4% and eczema for 16.3% of dermatological consultations.
Dermatological disorders make up a significant proportion of general practitioners' workload. The diagnostic profile of primary-care dermatology differs markedly from that of hospital practice. General practitioners may benefit from training specifically tailored to the common primary-care dermatological conditions.
SourceAvailable from: Maeve Howett[Show abstract] [Hide abstract]
ABSTRACT: The purpose of this article is to describe a novel service-learning opportunity for graduate nursing students that promotes competency in dermatology. A hybrid service-learning course with online didactic content is described, along with tools for evaluation of dermatology competencies. Student evaluation of the course is discussed, and selected research articles are reviewed. Advanced practice nursing and medical education frequently does not adequately prepare primary care providers to be competent in the assessment and management of dermatologic conditions. Embedding dermatology content in a service-learning program can optimize the provision of care, strengthen competencies in dermatology and inter-professional care, and allow students to gain a deeper understanding of the population with which they work. The innovative service-learning program presented is a model for advanced practice nursing education. Tools for evaluating clinical competency and courses often need validation. [J Nurs Educ. 2014;53(12):710-713.]. Copyright 2014, SLACK Incorporated.Journal of Nursing Education 12/2014; 53(12):710-713. DOI:10.3928/01484834-20141118-15 · 0.76 Impact Factor
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ABSTRACT: Introduction There are few studies on the prevalence of skin diseases, and very few reports of the percentage of consultations for dermatological reasons in primary and specialized care. Objectives Since most of studies of dermatology in primary care have focused on referrals to secondary care or emergency dermatology services, we aimed to study consultations for dermatologic problems in primary and specialized care. We also aimed to assess the percentage of diagnostic agreement between dermatologists and primary care physicians. Material and method We conducted an observational, descriptive, cross-sectorial study over a 3-month period in a primary care center in our health district and in our specialized outpatient unit in the Virgen de Macarena District in Seville (Spain). Results Consultations for dermatological reasons in health centers constitute a significant percentage (5.4%) of visits. The most common reason for consultation was eczema. Most patients were treated by the primary care physician without the need for referral. The percentage of diagnostic agreement between primary and specialized care was 27.3%. Discussion The high demand for consultations due to dermatological reasons in health centers justifies the need for adequate training in dermatology among primary care physicians. Most patients attended in general dermatology consultations (93.6%) are discharged without further follow-up. Comparison of the results of our study with those of the few studies available on the topic revealed differences in attendance rates and diagnostic agreement.Piel 01/2014; 29(1):4–8. DOI:10.1016/j.piel.2013.06.007
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ABSTRACT: Store-and-forward teledermatology (TD) or asynchronous TD is an invaluable tool in providing dermatologic healthcare from a distance to rural communities, or to communities where distance, geographical isolation and/or patient transportation to specialized health centers are decisive factors that delay or may even impede timely access to dermatological care. In Chile, many communities live in the aforementioned circumstances and require the availability of a functioning TD program.Piel 12/2014; 30(3). DOI:10.1016/j.piel.2014.07.007