Criteria-based audit of phototherapy unit in treatment of psoriatic patients in Department of Dermatology, Venereology and Andrology in Assiut University Hospital

Background
The use of phototherapy continues to be a principal treatment option in a prevalent disease such as psoriasis and expertise in delivering therapeutic phototherapy is essential within the specialty of dermatology. Clinical audit is the balance that helps us to assess how well we are performing our daily practice against research evidence-based criteria. It is a multidisciplinary tool involving all members of healthcare team.
Objectives
The aim of this study is to assess how useful criteria-based management audit is in improving medical records and how far it helps in the overall cost of care of psoriatic patients attending the Phototherapy Unit of Dermatology Department, Assiut University Hospital.
Patients and methods
A rapid review was conducted to 32 psoriatic patients referred to the phototherapy unit and a quasi-experimental design (audit) of our experience with phototherapy in the treatment of psoriasis was performed retrospectively over a 6 months period from May to November 2018. That was followed by a successive prospective 6 months sustained improvement period from December 2018 to May 2019 following the standards defined by the British Association of Dermatologists phototherapy service guidelines 2018.
Results
Most of the criteria were fulfilled and achieved 100% outcome but the rest were deficient; the most significant were absence of written consent and absent discharge protocol. Patients’ records did not include the skin type, minimal erythema dose, minimal phototoxic dose and total cumulative dose which necessary for skin cancer surveillance. Only 62.5% of the patients were subjected to Psoriasis Area Severity Index score measurement.
Conclusions
The present study demonstrated that the phototherapy unit varied in some issues in their capacity to meet international audit standards of British Association of Dermatologists guidelines in the management of psoriatic patients. We established most of the criteria and the reported deficiencies were corrected later during the improvement period.