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Management of a chronic skin disease in primary care: An analysis of early-career general practitioners' consultations involving psoriasis


Nawaz, S and Tapley, A and Davey, AR and Van Driel, ML and Fielding, A and Holliday, EG and Ball, J and Patsan, I and Berrigan, A and Morgan, S and Spike, NA and FitzGerald, K and Magin, P, Management of a chronic skin disease in primary care: An analysis of early-career general practitioners' consultations involving psoriasis, Dermatology Practical and Conceptual, 11, (3) pp. 1-10. ISSN 2160-9381 (2021) [Refereed Article]

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Copyright Statement

Copyright: 2021 Nawaz et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license, ( which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.

DOI: doi:10.5826/dpc.1103a55


Background: The management of psoriasis by general practitioners (GPs) is vital, given its prevalence, chronicity, and associated physical and psychosocial co-morbidities. However, there is little information on how GPs (including early-career GPs) manage psoriasis.

Objectives: This study assessed the frequency with which Australian specialist GP vocational trainees ('registrars') provide psoriasis care and the associations of that clinical experience.

Methods: A cross-sectional analysis was done of data from the ReCEnT study, an ongoing multi- site cohort study of Australian GP registrars' experiences during vocational training. In ReCEnT, 60 consecutive consultations are recorded 3 times (6-monthly) during each registrar's training. The outcome factor for this analysis was a problem/diagnosis being psoriasis, and independent variables were related to registrar, patient, practice and consultation factors. This study analysed 17 rounds of data collection (2010-2017) using univariate and multivariable regression.

Results: Data from 1,741 registrars regarding 241,888 consultations and 377,980 problems/diagnoses were analysed. Psoriasis comprised 0.15% (n=550) of all problems/diagnoses (95% CI, 0.13-0.16). Significant patient multivariable associations of a problem/diagnosis being psoriasis included age, gender, being new to a practice or a registrar, and psoriasis being an existing problem rather than a new diagnosis. Significant registrar associations included seeking in-consultation information/assistance, not scheduling a follow-up appointment, prescribing medication, and generating learning goals.

Conclusions: Australian registrars have modest training exposure to psoriasis and may find psoriasis management challenging. Furthermore, continuity of care (essential for optimal chronic disease management) was modest. The findings have implications for GPs' approaches to the management of psoriasis more widely as well for general practice education and training policies.

Item Details

Item Type:Refereed Article
Keywords:chronic disease, continuity of patient care, family practice, general practice, medical and graduate education, psoriasis
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Dermatology
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:FitzGerald, K (Dr Kristen FitzGerald)
ID Code:146286
Year Published:2021
Deposited By:Medicine
Deposited On:2021-08-27
Last Modified:2021-09-30
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