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Face-to-Face consultations for older patients with skin diseases sees optimization of GeriDerm clinic service

  • Jan 18, 2021
  • Author: QT-Online
  • Number of views: 19806
  • Health/Medicine
The Geriatric-Dermatology (GeriDerm) clinic has expanded its patient care services by adding face-to-face consultations to virtual sessions for older patients with skin diseases in Qatar. From January 2021, all new referrals to the clinic will be seen by an interdisciplinary team of dermatologists and geriatricians in a specialized Hamad Medical Corporation facility for the patient’s first appointment. 
The ‘GeriDerm’ clinic was first launched in June 2020 as a virtual clinic providing specialized telemedicine-based care to cover the medical needs of older patients with dermatological problems. The provision of virtual and telephone consultations was initiated when the challenges of access to care due to the COVID-19 pandemic became more apparent. 
The GeriDerm clinic had 329 virtual encounters with older patients from June-December 2020; with approximately 40 patients being seen in the clinic where  face-to-face consultation was deemed essential.
Resuming  face to face is in accordance with clinical guidelines and new patients are now receiving appointments to be seen by clinical experts in the Dermatology and Venereology Department or the Elderly Day Care Unit in Rumailah Hospital.  as well as continue their ongoing care online. Follow up appointments will be arranged as either in-person or virtual consultation, depending on clinical need and patient preference.
The development of the ‘GeriDerm’ clinic was led by Dr. Sarah Al-Khawaga from HMC’s Dermatology and Venereology Department,  in close collaboration with Dr. Wasim Akram, Geriatric Consultant at Rumailah Hospital, with the support and guidance of Prof. Steinhoff, Chairman, of the Dermatology Department and Director of the Dermatology Institute at HMC,  and Dr. Hanadi Al-Hamad, National Lead for Healthy Ageing in Qatar and Medical Director of Rumailah Hospital (RH) and Qatar Rehabilitation Institute (QRI). 
Dr. Al-Khawaga explained the growing need for providing specialized dermatological care for older adults: “Skin disorders are more common in older adults, because the skin becomes is dryer (less oily), less elastic and thinner with advancing age, which can make it more susceptible to disease. The most common skin diseases among older people include eczema, skin infections, and pruritus (severely dry and itchy skin). People with underlying health conditions, such as diabetes, or those who take multiple medications, can also experience increased skin problems.” 
“The COVID-19 pandemic last year provided the impetus for the establishment of the Geriatric Dermatology telemedicine clinic as an innovative approach to deliver ongoing care to older patients. The virtual service was welcomed by many patients and their families because it reduced the risk of infection through exposure outside their home; it was also more convenient for some patients with specific health conditions and limited transport means. However, in light of the clinical need to physically examine certain patients, especially during first time appointments, HMC’s clinical leadership team approved face-to-face consultations to enhance patient centered care,” added Dr. Al-Khawaga.
The United Nations states that the world’s population is ageing, and the population of people aged 65 and over is growing faster than all other age groups globally. The incidence of dermatological conditions is also rising in parallel and the specialized care needed for this population group has led to the need to adapt healthcare provisions to the medical needs of older persons. 
“The goal for the GeriDerm clinic is to promote early detection of dermatological conditions, especially in high-risk patients aged 65 years and above. This clinic addresses one of the most vulnerable population groups during the current COVID-19 pandemic through the provision of clear pathways for proper triaging, referrals, and minimal exposure to infection,” said Dr. Akram.
“The management of complex cases warrants physical examinations and we can now provide a range of care that is more tailored to our patients’ needs. The ‘GeriDerm’ service aims to achieve the best standard of healthcare provisions for older adults during the COVID-19 pandemic; it also serves as a continuous advanced technology-based framework for the care of older patients with skin disease going forward,” Dr. Akram added.
Patients aged 65 and older can be referred through their primary health center, or if they are seeing another HMC doctor who recommends an expert consultation they can also arrange a referral.  To help triage patients for urgent and non-urgent appointment bookings, the assigned dermatologist performs a GeriDerm risk assessment using an international best practice tool and triaging process. Urgent referrals, especially for suspected skin melanomas, aim to  refer patient within 24 to 48 hours. 
The GeriDerm clinic is held currently held from 7:00 AM to 3 PM, every Tuesday. The virtual and direct clinics are managed by multidisciplinary dermatologists and geriatricians, along with experienced nurses and allied health professionals, to provide the best possible service.
The experts advocate basic good skincare tips for the elderly, which include washing the skin gently and avoid vigorous rubbing; moisturizing the skin regularly with emollients/moisturizers; avoid direct sun exposure when applicable and use proper broad-spectrum sunscreen protection with an SPF 30 and above; maintain a balanced diet with proper fluid intake to avoid dehydration, and finally to consult your dermatologist in case of persistent dry itchy skin, rash, or blisters.