Outcome measures for interdisciplinary care in immune-mediated inflammatory skin diseases: a scoping review.

Abstract

There is a growing trend towards interdisciplinary care (IC) for the management of immune-mediated inflammatory skin diseases (skIMIDs). However, an overview of instruments used to evaluate whether IC is superior to usual care is currently lacking. This scoping review aims to gain insight into clinician- and patient-reported outcome measures (ClinROMs and PROMs) used in IC for skIMIDs. A comprehensive literature search was conducted by screening PubMed, Web of Science and Embase databases from their inception until October 2024. To be eligible, studies needed to have investigated IC for skIMIDs involving dermatologists, and have reported either ClinROMs or PROMs. Two independent reviewers screened all records by title, abstract and full text, with conflicts resolved by a third reviewer. Fourteen studies were included in this review. Nine investigated IC for psoriasis (PsO), four for atopic dermatitis (AD) and one for hidradenitis suppurativa. Six PsO studies examined combined dermatology-rheumatology clinics, while four studies explored collaborations with psychiatrists or psychologists for PsO or AD. The remaining IC models were diverse. A total of 49 different ClinROMs and PROMs were reported across the included studies, with 38 being reported by only one study. Except for the Dermatology Life Quality Index (used by 12 studies), body surface area (used by four studies), Psoriasis Area and Severity Index (used by all PsO studies), and Eczema Area and Severity Index or SCORing Atopic Dermatitis (used by all AD studies), the reported ClinROMs and particularly PROMs vary widely. Although several studies describe IC models for skIMIDs, few investigated their impact on ClinROMs or PROMs. The heterogeneous outcomes used pose a challenge for comparison across studies. This review highlights the need for consensus on a core set of outcome measures for IC in skIMIDs to create a common language among the healthcare providers involved, and enhance comparability between studies. Implementing standardized outcome measures for IC in skIMIDs could contribute to the development of evidence-based guidelines and ultimately, improve patient care.