How a Danish study unmasks psoriasis wait time

Danish study explores waiting and clinical management for people with psoriasis — crucial for effective management of this chronic disease.

In brief: 

• Study explores waiting and clinical management times for individuals with psoriasis in Denmark (in 2019-2022).
• The average waiting time from referral by a general practitioner to the first visit to a private-practice dermatologist was 62 days.
• Individuals with psoriasis undergo private-practice dermatologist management for approx. 3.5 years before hospital referral.

Psoriasis is a chronic autoimmune disease that affects the skin, causing inflammation, redness and scaling. The severity of the disease can vary, from mild to severe, often characterized by periods of flare-ups followed by remission.

 A Danish register study unveiled a 2.2% prevalence of psoriasis, accompanied by incidence rates ranging from 107.5 to 199.5 per 100,000 person-years throughout the 2003-2012 span. Additional more recent estimations based on a skin cohort of Danish adults yielded a 7.9% prevalence of physician-diagnosed psoriasis in 2019.

Psoriasis not only manifests physical symptoms but also detrimentally affects individuals' quality of life, prompting self-consciousness, embarrassment and psychological distress. Associations between psoriasis and comorbidities like psoriatic arthritis, cardiovascular ailments and specific cancer types have been established. Although a definitive cure remains elusive, numerous treatment options exist to effectively manage symptoms, underscoring the crucial role of closely monitored care and follow-up from healthcare professionals, including general practitioners and dermatologists.

Regrettably, an extensive three-year waiting period impedes the prompt dermatological intervention of psoriasis patients in Denmark. Hence, this study aims to explore the waiting and clinical management times for persons with psoriasis in Denmark based on real-world data from registers. The report succinctly details the study's objectives, methodologies and findings in subsequent sections.

Study objectives

This observational retrospective cohort study leverages population-level data from Danish registers to investigate the waiting times and clinical management times experienced by individuals seeking specialized healthcare for psoriasis.

The study's primary focus is to meticulously examine and document the intervals that transpire between referrals made by general practitioners (GPs) and subsequent engagements with private-practice dermatologists (PPDs), as well as the initiation of management at dermatological hospital departments.

Specifically, the study endeavors to meticulously map the regional waiting times from the moment of GP referral to the initial appointment with a PPD, closely monitoring the changes in these durations throughout the 2019-2022 timeframe.

Additionally, the investigation endeavors to chart the regional waiting times from a patient's referral by a PPD to their inaugural visit to a dermatological hospital department for undertaking psoriasis management, meticulously tracking the evolution of these periods over the same duration.

Furthermore, a secondary objective of the study is to assess the regional variances and fluctuations in the length of time individuals with psoriasis are managed by PPDs before being referred to dermatological hospital departments.

By achieving these objectives, the study aims to deliver an all-encompassing and updated comprehension of the waiting and clinical management times experienced by individuals with psoriasis in Denmark.

Key findings and results

• The average waiting time from referral by a GP to the first visit to a PPD was 62 days (in 2019 and 2022).
• Average waiting time from referral by a PPD to the first visit at a dermatological hospital department was 57 days during the same period.
• Notable variations in waiting times were observed across regions, with the North Denmark Region experiencing shorter waiting times.

Specifically, waiting times from GPs to PPDs were longer in 2021, whereas waiting times from PPDs to dermatological hospital departments were longer in 2020 compared to other years within the 2019-2022 timeframe.

• These variations can be attributed to the influence of the COVID-19 pandemic.
• On average, individuals with psoriasis underwent management by PPDs for approximately three years and six months before being referred to a dermatological hospital department.

Psoriasis, a chronic autoimmune disease characterized by skin inflammation, redness and scaling, lacks a definitive cure. However, numerous treatment options exist to effectively manage its symptoms. Close monitoring and follow-up from healthcare professionals are crucial as the condition progresses. Timely access to healthcare is of paramount importance for individuals with psoriasis, necessitating an understanding of waiting times in both primary and secondary healthcare sectors. The aim of this study was to gain insights into waiting times and clinical management durations for individuals with psoriasis in Denmark. Real-world data obtained from Danish registers were employed to achieve this objective.