PD08: Patient-reported outcomes and phototherapy preassessment: an introduction to a new mobile phone-based system

M. Steyn,¹ R. Sarkany,¹ H. Fassihi,¹ M. Sweeney² and J. Ferguson¹

¹St John’s Institute of Dermatology, Guy’s and St Thomas’ Hospital and ²DrDoctor, London, UK

Phototherapy is an effective treatment for a variety of inflammatory skin conditions. We introduced a mobile phone-based patient-reported preclinical questionnaire between June 2020 and January 2021, in order to optimize use of nursing time and collect information on diagnosis, treatment modality, topical and oral therapies, Fitzpatrick skin type, quality of life (QoL) data (generic and disease specific), distance travelled, self-reported ethnic group and age. Recently, we introduced a second questionnaire repeating QoL measures after the patients completed treatment to assess the impact of phototherapy on QoL, including disease-specific measures of QoL and severity. A total of 622 patients were referred to our unit from 1 February 2020 to 31 January 2021. The majority of referrals were from within a 10-mile radius of the unit (67%); 45% were from our immediate catchment area. Fifty per cent identified as white, 26% as black and 11% as Asian. In total, 310 patients completed the preclinical questionnaire over a period of 6 months (77% completion rate). Seventy per cent of referrals were for narrowband ultraviolet (UV)B, 13% for psoralen + UVA and 7% for UVA1. The majority of referrals were for a diagnosis of psoriasis (n = 105; 33·9%), followed by eczema (n = 72; 23·2%), vitiligo (n = 36; 11·6%) and mycoses fungoides (n = 18; 5·8%). Nodular prurigo, polymorphous light eruption, urticaria, granuloma annulare, lichen planus and morphoea made up a minority. Average pretreatment Dermatology Life Quality Index (DLQI) was 12·47 (scores range from 0 to 30; scores > 10 indicate the patient’s life is severely affected by their skin disease) and Patient’s Global Assessment (PaGA; scores range from 0 to 5; or clear, nearly clear, mild, moderate, severe, very severe) was 3·03 (moderate). Patients with eczema scored high (DLQI 14·3, PaGA 2·99), followed by psoriasis (DLQI 13·67, PaGA 3·18) and vitiligo (DLQI 8·19, PaGA 2·92). High DLQI scores were also seen in nodular prurigo (n = 4; 15·25), urticaria (n = 1; 11·00), lichen planus (n = 4; 18·00) and chronic actinic dermatitis (n = 1; 17·0). Overall, this patient-completed mobile phone-based system is easy for patients to complete, saves nurses’ time in phototherapy preassessment, allows nursing time to be reallocated to clinical assessments and quality patient interaction, and has the prospect of providing an easy way of measuring changes in QoL related to treatment with phototherapy.