ABSTRACT
Background: Psoriasis (PsO) and musculoskeletal manifestations are common among patients with psoriatic arthritis (PsA). A shared-care model between rheu-matologists and dermatologists has been advocated to promote early diagnosis and improve management care. Data from Asia is scanty. Patients' and learners' experience of shared-care models are seldom explored. Objectives: We described the set-up of a new shared-cared PsA-PsO clinic incorporating service, education and research between rheumatologist and dermatologist for PsA. We describe the patients' and learners' experience of this shared-care model. Methods: A combined care clinic was newly set up in 2019. Referrals were Internal through either specialty. Each patient was frst seen by a trainee, followed by both a dermatologist and rheumatologist simultaneously in the same consultation room. We collected patients' and learners' experience through self-administered survey. Results: From May 2019 to January 2020, data from 44 visits (55% new referrals, 45% follow-up) from 28 patients were captured in the PsA-PsO clinic. 50% of cases were referred from either specialty. 34% were referred for diagnostic doubts, 66% were for therapeutic issues. 61% of patients continued follow-up in the PsA-PsO clinic, and 39% discharged back to respective care. From patients' experience rated on scale from 0-10, median (interquartile range, IQR) rating of the care was 8 (7, 8). 69.2% and 96% of patients would recommend the care to others. Free text comments included enhanced convenience, time saving, and having both specialties input on management. From 20 learners (3 medial students, 12 residents, 4 senior residents and one scientist), 95% reported extremely or very benefcial to training, 77.8% reported improved confdence in care for PsA and/or PsO patients. The PsA-PsO clinic was temporally suspended during the Covid-19 viral pandemic since February 2020 due to lack of manpower and not fulflling the spacing out requirement for infectious control. The service was resumed gradually from May 2021. Conclusion: Despite challenges, we report the setup of a new care model between dermatologists and rheumatologists for care of patients with psoriatic disease. The care model was well received by patients. Learners from various levels reported beneft from the learning experience.