关键词: Maintenance of Certification Performance Improvement CME comorbidities counseling patients evidence-based medicine part IV patient outcome physician performance practice gaps psoriasis psoriasis guidelines shared decision making

Mesh : Adult Aged Clinical Competence Dermatology / education Education, Medical, Continuing / methods Humans Middle Aged Psoriasis / therapy Quality Improvement Surveys and Questionnaires

来  源:   DOI:10.1016/j.jaad.2014.11.010

Abstract:
BACKGROUND: The Performance Improvement (PI) CME format improves physician performance in other specialties but data are lacking in dermatology.
OBJECTIVE: We sought to assess the impact of a PI CME activity on physician practice patterns for patients with psoriasis, which was developed, implemented, and evaluated by the American Academy of Dermatology (AAD), in part to assist dermatologists in fulfilling Part IV of their Maintenance of Certification requirements.
METHODS: In this PI CME activity, participants: (1) self-audited patient charts, which met inclusion criteria in stage A, and reflected on their results, benchmarked against peers; (2) reviewed educational materials in stage B and developed an improvement plan; and (3) self-audited a different set of patient charts following the plan\'s implementation. Aggregate stage A and C data were analyzed using χ(2) tests.
RESULTS: We found a statistically significant improvement in the advisement of patients with psoriasis regarding their increased risk for cardiovascular disease, to contact their primary care provider for cardiovascular risk assessment, and in shared decision making regarding the treatment plan. We also found an overall statistically significant improvement in history taking per the guidelines.
CONCLUSIONS: Learner chart selection bias, self-reporting of chart data, and lack of a control group are limitations.
CONCLUSIONS: The AAD psoriasis PI CME activity demonstrated significantly improved dermatologists\' documentation of patient\'s history, counseling of patients for lifestyle behaviors, and shared decision making.
摘要:
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