The IMPACT Pso Well® practitioner training: motivational interviewing and psoriasis management

Abstract

Background Psoriasis is a common long-term, immune-mediated skin condition exacerbated by smoking, excess alcohol and obesity. Engaging in a healthy lifestyle is important for management of psoriasis. Motivational interviewing (MI) is an evidence-based approach to supporting behaviour change but has not been used to help clinicians working with patients with psoriasis. The ‘Pso Well®’ (Psoriasis and Wellbeing) training was designed to provide clinicians with MI skills. Aim To investigate whether: 1) participating in the Pso Well® training intervention improves healthcare professionals’ behaviour change skills; 2) intervention delivery is feasible and 3) the programme is acceptable to clinicians. Methods Clinicians’ behaviour change skills were assessed objectively before and after training using the Behaviour Change Counselling Index (BECCI) to score audio-recorded practitioner-patient actor consultations. Feasibility and acceptability were explored in semi-structured interviews with practitioners following training and analysed thematically. Results Sixty-one practitioners completed the training (35 dermatology nurses; 23 dermatologists; 3 general practitioners). Practitioners’ BECCI scores increased significantly post-training (t(54)=8.37,p<.01; eta2=0.56). Thematic analysis revealed that practitioners valued the training and reported they gained new skills relevant to their practice, they also wanted further training to consolidate the skills. Conclusion The Pso Well® training may improve healthcare practitioners’ behaviour change skills in relation to psoriasis management. Clinicians judged training content to be relevant and useful though further opportunity for skills consolidation may be needed. Given that psoriasis is mainly managed in primary care, unexpectedly few general practitioners attended. Investigation of the impact of the intervention on patient outcomes is now required.