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Points to Consider in the Foundation of Multidisciplinary Units for Psoriatic Arthritis: A Delphi Study and a Systematic Review of the Literature

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Abstract

Introduction

In numerous clinical practice guidelines, emphasis is placed on the need for coordinated care of psoriatic arthritis (PsA) between rheumatologists and the objective was to develop experience-based points to consider facilitating the implementation of multidisciplinary units (Dermatology/Rheumatology) for the management of patients with PsA.

Methods

A scientific committee of rheumatology and dermatology experts in the management of PsA, and with experience in joint care, discussed the critical aspects of multidisciplinary PsA Units. The discussion became the basis for a Delphi survey in two rounds submitted to a panel of 24 specialists in rheumatology and dermatology not involved in PsA units. The statements and practices that reached a consensus were summarized and further elaborated.

Results

After two Delphi rounds, agreement was reached for 49 of the 50 proposed statements. These included a justification of the units, objectives, and utilities, as well as operational aspects of the units, such as the minimal and ideal premises, referral criteria, and necessary resources. The statements were compiled in 11 points to consider.

Conclusions

This consensus offers some points to consider, including premises and recommendations, for the development of specialized Units in the management of PsA based on expert opinion. We trust these guidelines may facilitate their implementation in the future.

Funding

Pfizer.

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Acknowledgments

The authors would like to make a special mention and show their gratitude to the panelists that participated to the voting according to the Delphi methodology and prepared this document: Mariano Ara Martin, Jose Luis Alvarez Vega, Sagrario Bustabad Reyes, Antonio Javier Chaves Alvarez, Pablo de la Cueva Dobao, Concepción Delgado Beltran, Carmen Maria Escudero Gonzalez, Eva Galindez Agirregoikoa, Francisco Jose Guimera Martin-Neda, Rosa Izu Belloso, Gemma Marquez Balbas, Amparo Marquina Vila, Angels Martinez Ferrer, Lourdes Mateo Soria, Virginia Moreira Navarrete, Maria Teresa Navio Marco, Susana Perez Santos, Alberto Romero Mate, Inmaculada Ros Vilamajo, Rosa Taberner Ferrer, Claudia Urrego Laurin, Ana Urruticoechea Arana, Raul Veiga Cabello, and Beatriz Yoldi Muñoz. The authors also appreciate the editorial support given by Nature Publishing Group Iberoamerica and Dr Pablo Rivas in the preparation of this manuscript. The scientific meetings, Delphi survey, and medical writing services were funded by Pfizer Spain. No funding was received for publication charges. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.

Disclosures

Jordi Gratacos has received a speaker honorarium from Company MSD, Pfizer, Novartis, Janssen, Celgene and Abbvie. Pedro Zarco has received a speaker honorarium from Company MSD, Pfizer, Novartis, Janssen, Celgene and Abbvie. Ana M. Carrizosa-Esquivel has received a speaker honorarium from Company MSD, Pfizer, Novartis, Janssen, Celgene and Abbvie. M. Dolores Ruiz-Montesino has received a speaker honorarium from Company MSD, Pfizer, Novartis, Janssen, Celgene and Abbvie. Jose Antonio Román-Ivorra has received a speaker honorarium from Company MSD, Pfizer, Novartis, Janssen, Celgene and Abbvie. Jesus Luelmo has received a speaker honorarium from Company Pfizer, Novartis, Janssen, Celgene and Abbvie. Rafael Botella-Estrada has received a speaker honorarium from Company Pfizer, Novartis, Janssen, Celgene and Abbvie. M. Luz Garcia-Vivar has received a speaker honorarium from Company Pfizer, Novartis, Janssen, Celgene and Abbvie. Silvia Perez-Barrio has received a speaker honorarium from Company Pfizer, Novartis, Janssen, Celgene and Abbvie. Jose Luis Lopez-Estebaranz has received a speaker honorarium from Company Pfizer, Novartis, Janssen, Celgene and Abbvie. None of these companies had any role in the date of the study or in the elaboration of the final manuscript.

Compliance with Ethics Guidelines

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964, as revised in 2013. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Hospital Universitario Parc Tauli de Sabadell, IPT.UAB, Barcelona, Spain

    Jordi Gratacos-Masmitja & Jesus Luelmo-Aguilar

  2. Alcorcon Foundation University Hospital, Madrid, Spain

    Pedro Zarco-Montejo & Jose Luis Lopez-Estebaranz

  3. Hospital Universitari i Politecnic La Fe, Barcelona, Spain

    Rafael Botella-Estrada

  4. Virgen Macarena Hospital, Seville, Spain

    Ana Maria Carrizosa-Esquivel & Maria Dolores Ruiz-Montesino

  5. Basurto University Hospital, Bilbao, Spain

    Maria Luz Garcia-Vivar & Silvia Perez-Barrio

  6. Hospital Universitari i Politecnic La Fe, Valencia, Spain

    Jose Antonio Roman-Ivorra

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  1. Jordi Gratacos-Masmitja
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  2. Jesus Luelmo-Aguilar
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Correspondence to Jordi Gratacos-Masmitja.

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Gratacos-Masmitja, J., Luelmo-Aguilar, J., Zarco-Montejo, P. et al. Points to Consider in the Foundation of Multidisciplinary Units for Psoriatic Arthritis: A Delphi Study and a Systematic Review of the Literature. Adv Ther 33, 2150–2159 (2016). https://doi.org/10.1007/s12325-016-0429-z

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