The use of combined screening tools by practice-based pharmacists to identify psoriatic arthritis


Rod Tucker


Rotherham Doncaster & South Humber NHS Trust



Psoriatic arthritis (PsA) is a progressive, inflammatory joint disease with a peripheral and axial phenotype that is diagnosed by a rheumatologist. PsA affects around 8% of patients with plaque psoriasis yet often remains undiagnosed in primary care, possibly due to a lack of awareness of the condition and the high prevalence of non-specific joint pain. Although screening provides an opportunity to increase detection, it is likely to increase general practitioner workload. Utilising practice-based pharmacists to manage the screening and referral process could provide an alternative means for detecting previously undiagnosed patients.


To utilise practice-based pharmacists to screen patients with psoriasis in an effort to identify those with undiagnosed PsA.


Clinical pharmacists undertook screening of patients with psoriasis, organised relevant blood tests and a rheumatology referral where screening indicated that PsA was likely.


A total of 276 patients were identified in five practices of which 184 (66%) returned the screening forms. A total of 18 patients (9.7%) met the criteria for referral, of which 13 were subsequently seen by a rheumatologist resulting in a single case where PsA was diagnosed.


The low prevalence of PsA detected suggests a limited role for primary care screening. A more valuable role for such pharmacists might be in conducting e-medication reviews and to deliver educational advice to raise awareness of PsA. Future studies should explore the value of such pharmacist-led educational campaigns and the extent to which this strategy increases the diagnosis of undetected PsA.

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