From theory based research to service development: integrating behaviour change with psoriasis management

Abstract

Psoriasis is not considered a serious enough medical condition to warrant a dedicated psychological service despite the role of mood and behavioural factors in psoriasis being well established. Half of patients with Psoriasis are obese and inactive; nearly half smoke and a third use alcohol excessively. Up to 30% of people are depressed or anxious. Disease severity is not related to degree of distress and clinicians are not good at either guessing or systematically detecting distress or psychological (lifestyle issues). Patients report spending long periods being unmanaged, under-managed or even mismanaged in primary care; often given out of date information and treatments and no hope for future effective treatments. By the time they access specialist care they have well-established skin disease, low mood and motivation and have developed ineffective self –management skills and health behaviours. Many report cumulative life course impairment: low education levels; not seeking work –or doing jobs where they can easily hide; having poor relationship history and high levels of reported suicidal ideation. Our research programme ( www.impactpsoriasis.org.uk) provides a platform for a new integrated dermatology and psychology clinic. This presentation will do the following: 1. Outline the process of working from research study outputs to establishing a fit for purpose, cross-specialty service. 2. Identify the potential pitfalls to creating a new service in this ‘Cinderella’ specialty within a rapidly shifting landscape of care provision. 3. Discuss advantages of using this service development for future research idea generation and building research capacity.