Induction at 39 weeks cut c-section rate in first-time moms. In a recent international survey, dermatologists both in the United States and abroad acknowledged major gaps in their competence to provide high-quality care to reproductive-age women with psoriasis , Jenny Murase, MD, reported at the annual congress of the European Academy of Dermatology and Venereology.
Jenny E. Murase These shortcomings were documented in a survey, which began with Dr. Murase and her coinvestigators conducting detailed, minute-long, semistructured telephone interviews with 24 dermatologists in the three countries. Those interviews provided the basis for subsequent development of a minute online survey on psoriasis and pregnancy completed by American, German, and UK dermatologists.
The survey incorporated multiple choice questions and quantitative rating scales. Murase said. Among the key findings:. Fifty percent of dermatologists rated themselves as having suboptimal skills in discussing contraceptive methods with their psoriasis patients of childbearing potential. Consideration of treatment of psoriasis in pregnancy requires balancing potential medication risks to the fetus versus the possible maternal and fetal harms of under- or nontreatment of their chronic inflammatory skin disease.
But the survey showed that shared decision-making was often poorly integrated into clinical practice. Ninety-seven percent of the U. Of the relatively few dermatologists who were aware of such guidance, nearly half dismissed it as inapplicable to their clinical practice.
And one-third of the German dermatologists and roughly one-quarter of those from the United States and United Kingdom reported feeling pressure to make treatment decisions quickly and without patient input.
