Abstract / Summary
Abstract Background Managing skin diseases in nursing homes (NHs) is increasingly challenging, necessitating sustainable, and efficient dermatological care provision. Our main aim is to investigate developments in dermatological care within NHs over the past decade, and to identify recommendations for further quality improvement. Methods A repeated cross-sectional nationwide survey was conducted among elderly care physicians (ECP) working in NHs, comparing data with a ten-year interval (2013–2014 and 2024). The survey assessed the burden of skin diseases, diagnostics, treatments, collaboration with dermatologists, physician education/skills, and suggestions for improvement of dermatological care. Results A total of 744 physicians were included for comparison between the current (n = 397, response rate 25.5%), and historical (n = 347, response rate 30.6%) survey. Current respondents were significantly younger than historical respondents (40.6 ± 11.5 vs 43.9 ± 11.4 years, p<.001). Almost all (99.0%) ECPs regularly encountered dermatological problems in their patients. Confrontation with cutaneous (pre)malignancies (59.4% vs 71.0%, p<.001) increased the most over time, and remained the primary reason for dermatologist consultation (78.8%). Over time, the proportion of respondents using teleconsultation increased (31.6% vs 85.6%, p<.001), while telephone and on-site consultations declined (p<.001). There was an increase in availability of cryotherapy (25.6% vs 48.5%, p<.001), punch biopsy (15.4% vs 29.7%, p<.001), and dermoscopy (6.1% vs 11.9%, p=.007) within the NHs. Respondents suggested targeted (disease-specific) education and practical training to improve their knowledge and skills. To improve collaboration with dermatologists, respondents suggested dermatologists to further integrate patients’ general health status, and improve communication during medical decision making. Conclusions ECPs are frequently confronted with skin diseases. Encounters with cutaneous (pre)malignancies increased the most over time, and remained the primary reason for dermatologist consultation. Over the last decade, the use of teleconsultation, and the availability of diagnostic and treatment procedures in NHs increased. However, to bridge the gap between ECPs’ tool availability and their actual experience, future initiatives should focus on cutaneous (pre)malignancy education and skills training embedded within an interprofessional collaboration framework.