title: 'In someone's clinic but not in mine'--clinicians' views of supporting lifestyle behaviour change in patients with psoriasis: a qualitative interview study.
abstract: BACKGROUND
  Psoriasis is associated with significant comorbidity. Excess alcohol use, smoking and higher body mass index are all associated with psoriasis and may contribute to its onset and/or exacerbation. Lifestyle behaviour change (LBC) can be beneficial in the prevention of psoriasis and/or reduction of its severity. LBC techniques are effective when used properly by healthcare professionals.
  
  
  OBJECTIVE
  It is unknown whether clinicians managing patients with psoriasis are familiar with LBC techniques or are confident to deliver LBC support in routine consultations. This study aimed to elicit the views and attitudes of healthcare professionals in primary and secondary care about addressing LBC for patients with psoriasis.
  
  
  METHODS
  We carried out in-depth semistructured interviews with 23 dermatology specialist and general practitioners in English primary and secondary care settings stratified by discipline. Data were analysed using constant comparison and principles of Framework Analysis.
  
  
  RESULTS
  Clinicians recognized that lifestyle behaviours were important in psoriasis management, but believed it was not their role to facilitate LBC. Limited knowledge and skills to implement LBC principles and techniques underpinned their beliefs. Participants identified a need for training to enable the incorporation of LBC support activity into psoriasis services.
  
  
  CONCLUSIONS
  Clinicians are not yet trained to support patients with psoriasis with effective LBC methods. Training in these methods is needed to enable healthcare professionals to assess and manage psoriasis better.
authors: Dermatology Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.
authors: P A
authors: PA
authors: Nelson
authors: C
authors: C
authors: Keyworth
authors: A
authors: A
authors: Chisholm
authors: C J
authors: CJ
authors: Pearce
authors: C E M
authors: CE
authors: Griffiths
authors: L
authors: L
authors: Cordingley
authors: C
authors: C
authors: Bundy
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003880:Dermatology; D005260:Female; D058006:General Practice; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010819:Physician's Role; D010817:Physician-Patient Relations; D011565:Psoriasis / Q000523:psychology / Q000628:therapy*; D040242:Risk Reduction Behavior; D012944:Social Support