Integrated PsA Screening Framework Improves Outcomes in Dermatology Clinics

A 27-month quality improvement initiative across 26 dermatology clinics has demonstrated that systematic screening and assessment for psoriatic arthritis (PsA) can improve detection and disease management among patients with psoriasis (PsO). The study highlights a scalable clinical model that integrates validated screening tools into routine dermatologic care.

The initiative embedded the Psoriasis Epidemiology Screening Tool (PEST) and Psoriatic Arthritis Impact of Disease questionnaire (PsAID-12) into the electronic medical record system. All patients with PsO underwent initial PsA screening using the PEST. Those scoring ≥3 or with an existing PsA diagnosis completed the PsAID-12 to assess symptom burden.

Out of 6473 patients with PsO without known PsA, 37.2% completed the PEST. Among those, 12.5% screened positive (PEST ≥3) and went on to complete the PsAID-12. Notably, 24.3% of those patients had PsAID-12 scores >4, indicating an unacceptable symptom state. Of these, nearly 25% were referred to rheumatology, and 44.4% of referrals resulted in a new PsA diagnosis.

The study also showed clinical improvement over time. Among 493 patients who completed the PsAID-12 more than once, the average score decreased from 2.80 to 2.53. As the authors noted, this represented a “significant reduction (P<0.0001)” in disease impact.

“Our study demonstrates the feasibility of [International Dermatology Outcome Measures’] clinical framework in optimizing PsA screening, assessment, and quality of care,” the authors wrote.

For dermatology practices, the findings reinforce the importance of integrating structured PsA screening tools into electronic systems. Early identification of PsA can lead to timely rheumatology referral and help prevent irreversible joint damage. The framework provides a model for proactive, collaborative management of psoriatic disease, aligning with treat-to-target goals in both dermatology and rheumatology.

Reference
Romanelli S, Ball GD, Hamade H, et al. Streamlining psoriatic arthritis screening and management using the IDEOM clinical framework: a quality improvement initiative. J Drugs Dermatol. 2025;24(8):777-781. doi:10.36849/JDD.9210