[Teledermatology within Dutch nursing homes]. / Teledermatologie binnen Nederlandse verpleeghuizen.

Skin problems are common within the nursing home population and could have a significant impact on quality of life. As a form of long-distance consultation teledermatology offers several potential benefits within this frail population. In this review we discuss several aspects of teledermatology, especially in relation to the nursing home population. Several studies demonstrated that teledermatology is a cost-effective and easy-to-use consultation method, which could significantly reduce the amount of hospital visits. However, teledermatology is only used in a limited number of Dutch nursing homes in daily practice due to several factors. For the optimal implementation of teledermatological consultation there are some important logistical, legal and financial framework conditions. In conclusion, teledermatology has a lot to offer within the nursing home population and therefore teledermatology will hopefully be increasingly used in daily practice within the near future.

Dermatologic care of institutionalized elderly patients: a survey among dermatologists in the Netherlands.

BACKGROUND: dermatologists are expected to be increasingly confronted with institutionalized elderly patients, due to the rapidly ageing world population. OBJECTIVES: to determine the proportion of dermatologists visiting patients in nursing homes, together with the reasons for consultation, barriers to perform these visits and diagnostic and treatment patterns. MATERIALS & METHODS: a web-based questionnaire regarding dermatologic care in nursing home patients was developed by a multidisciplinary group of dermatologists, residents and elderly care physicians. A cover letter containing a link to the final questionnaire was sent by e-mail to all 661 dermatologists and dermatology residents in the Netherlands. RESULTS: a total of 130 eligible questionnaires were returned (19.7%). Most respondents (79.2%) never had contact with an elderly care physician concerning a nursing home patient. However, only 30.0% of the respondents ever visited a patient within a nursing home. The most common reasons for nursing home visits were cutaneous (pre)malignancies (51.4%), eczema/dermatitis (25.7%) and (pressure) ulcers (8.6%). The most important barriers mentioned to perform nursing home visits were a lack of time and indistinct and/or inadequate financial compensation. Diagnostic and treatment patterns often differed from the outpatient clinic due to various patient-related and logistic factors. CONCLUSION: dermatologists are frequently confronted with nursing home patients but only a minority visits patients within nursing homes. Lack of time and/or financial compensation seem important barriers.

Current Dermatologic Care in Dutch Nursing Homes and Possible Improvements: A Nationwide Survey.

OBJECTIVES: To assess the provision and need of dermatologic care among Dutch nursing home patients and to obtain recommendations for improvement. DESIGN: Cross-sectional nationwide survey. SETTING: All 173 nursing home organizations in the Netherlands. PARTICIPANTS: Physicians working in nursing homes. MEASUREMENTS: Web-based questionnaire concerning the burden of skin diseases in nursing home patients, diagnostic procedures and therapy, collaboration with dermatologists, physicians' level of education, and suggestions for improvement. RESULTS: A total of 126 (72.8%) nursing home organizations, with 1133 associated physicians participated in our study and received the questionnaire. A total of 347 physicians (30.6%) completed the questionnaire. Almost all respondents (99.4%) were recently confronted with skin diseases, mostly (pressure) ulcers, eczema, and fungal infections. Diagnostic and treatment options were limited because of a lack of availability and experience of the physicians. More live consultation of dermatologists was suggested as being important to improve dermatologic care. Other suggestions were better education, more usage of telemedicine applications, and better availability of diagnostic and/or treatment procedures like cryotherapy. CONCLUSION: Physicians in nursing homes are frequently confronted with skin diseases. Several changes in organization of care and education are expected to improve dermatologic care in nursing home patients.