A Health Care Disciplines Project: Establishment of a Specialized Clinic for the Management of Ano-Genital Lichen Sclerosus in a Tertiary Health Care Center in Iraq

Main Article Content

AHMED M LUTFI AL-IMAM

Abstract

Executive Summary
Lichen Sclerosus (LS) is a chronic dermatologic condition that mainly affects the genital region, and treatment is mainly with topical medications. However, the disease can have serious complications (including cancer) with profound consequences on the patient’s health, sexual and social life. This part of the project aims to establish a first-of-its-kind specialized clinic (in the largest health care institute in Iraq) for the optimal management of LS and reduction of its complications. Furthermore, this clinic will contribute to the medical community and the medical literature. The project will target a population of 50 patients over a period of 13 months divided into three phases: Phase-1 will focus on securing funds and creating the clinic space, phase-2 will invest in training the medical team, patient enrolment-education and patient management, and phase-3 will focus on patients’ follow-up and project evaluation. The project evaluation will run along all three stages (for analysis and stakeholders’ engagement), which will assess: The reduction in patient expenditure and overall cost on the health care system; the level of activity-success of the clinic; and the possibility of project replication in Iraq and other countries (with similar settings). The main obstacles are: Funding issues; political-financial corruption; and Iraqi society religious-social beliefs that can interfere with female patients’ enrollment. However, effective management of each problem will be deployed. In addition, benefits (especially cost reduction in the long term) will justify such a promising project. By creating an active-successful clinic and using a professional team, the project will: Increase patient-public awareness of LS; effectively treat patients; reduce complications; and improve the patient's quality of life. Collectively, in the long term, this will reduce patient expenditure and the overall cost of the health care system.
Keywords: Lichen Sclerosus, Ano-genital, females, Health Care Disciplines, Specialized Clinic.

Article Details

How to Cite
AL-IMAM, AHMED M LUTFI. A Health Care Disciplines Project: Establishment of a Specialized Clinic for the Management of Ano-Genital Lichen Sclerosus in a Tertiary Health Care Center in Iraq. Medical Research Archives, [S.l.], v. 2, n. 6, nov. 2015. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/453>. Date accessed: 25 apr. 2024.
Keywords
Lichen Sclerosus, Ano-genital, females, Health Care Disciplines, Specialized Clinic.
Section
Research Articles

References

Abdelbaky, A. M., Aluru, P., Keegan, P., & Greene, D. R. (2012). Development of male genital lichen sclerosus in penile reconstruction skin grafts after cancer surgery: An unreported complication. BJU International, 109(5), 776–779.

Bass, B. M., & Avolio, B. J. (1993). Transformational leadership and organizational culture. Public Administration Quarterly, 112–121.

Bennis, W. (1984). The Four Competencies of Leadership. In: An Invented Life: Reflections on Leadership and Change (pp. 1–6).

Burrows, L. J., Creasey, A., & Goldstein, A. T. (2011). The treatment of vulvar lichen sclerosus and female sexual dysfunction. The Journal of Sexual Medicine, 8(1), 219–222.

C. B. Bunker & S. M. Neill. (2010). The Genital, Perianal and Umbilical Regions. In: B. Tony, B. Stephen, C. Neil, G. Christopher (Eds.), Rook’s Textbook of Dermatology (8th ed., pp. 3705–3806). Oxford, UK: Wiley-Blackwell.

Cameron, E., & Green, M. (2012). Making Sense of Change Management: A Complete Guide to the Models, Tools and Techniques of Organizational Change. 3rd ed. England: Kogan Page.

Chi, C. C., Kirtschig, G., Baldo, M., Lewis, F., Wang, S. H., & Wojnarowska, F. (2012). Systematic review and meta-analysis of randomized controlled trials on topical interventions for genital lichen sclerosus. Journal of the American Academy of Dermatology, 67(2), 305–312.
Dasgupta, P., Sen, A., & Marglin, S. (1972). Guidelines for Project Evaluation. Guidelines for Project Evaluation.

Dyer, W. G., Dyer, W. G., & Dyer, J. H., (2010). Team Building: Proven Strategies for Improving Team Performance (4th ed.). England: Wiley.

Fistarol, S. K., & Itin, P. H. (2013). Diagnosis and treatment of lichen sclerosus. American Journal of Clinical Dermatology, 14(1), 27–47.

Funaro, D., Lovett, A., Leroux, N., & Powell, J. (2014). A double-blind, randomized prospective study evaluating topical clobetasol propionate 0.05% versus topical tacrolimus 0.1% in patients with vulvar lichen sclerosus. Journal of the American Academy of Dermatology, 71(1), 84–91.
Goldstein, A. T., Creasey, A., Pfau, R., Phillips, D., & Burrows, L. J. (2011). A double-blind, randomized controlled trial of clobetasol versus pimecrolimus in patients with vulvar lichen sclerosus. Journal of the American Academy of Dermatology, 64(6), e99–e104.

Goleman, D. (1998). Working with Emotional Intelligence. London: Bloomsbury.

Green, J., & South, J. (2006). Evaluation: Key concepts for public health practice.

Jisc: Creative Commons BY-NC-ND (2013). Project planning: Evaluation plan. Retrieved from: http://www.webarchive.org.uk/wayback/archive/20140614222613/http://www.jisc.ac.uk/fundingopportunities/projectmanagement/planning/evaluation.aspx

Kanter, R. (2002). The enduring skills of change leaders. In: F. Hesselbein and R. Johnston (Ed.), On Leading Change, (pp. 47–59). New York: Jossey-Bass.
Keyonzo, N. A. (1989). Project evaluation guidelines. Afya, 23(1), 25.

Kosara, R., & Miksch, S. (2002). Visualization methods for data analysis and planning in medical applications. International Journal of Medical Informatics, 68(1), 141–153.

Kotter, J. P. (1995). Leading change: Why transformation efforts fail. Harvard Business Review, 73(2), 59–67.

Lewin, K. (1951). Field Theory in Social Science. New York: Harper and Row.
Milburn, K., Fraser, E., Secker, J., & Pavis, S. (1995). Combining methods in health promotion research: Some considerations about appropriate use. Health Education Journal, 54, 347–56.

Nasca, M. R., Innocenzi, D., & Micali, G. (2006). Association of penile lichen sclerosus and oncogenic human papillomavirus infection. International Journal of Dermatology, 45(6), 681–683.

Neill, S. M., Lewis, F. M., Tatnall, F. M., & Cox, N. H. (2010). British Association of Dermatologists’ guidelines for the management of lichen sclerosus 2010. British Journal of Dermatology, 163(4), 672–682.

Patsatsi, A., Kyriakou, A., Vavilis, D., Mantas, A., Patsialas, C., & Sotiriadis, D. (2013). A therapeutic approach for female, relapsing genital lichen sclerosus: A single-center study. Journal of Dermatological Treatment, 24(5), 336–339.

Rathi, S. K., & D’Souza, P. (2012). Rational and ethical use of topical corticosteroids based on safety and efficacy. Indian Journal of Dermatology, 57(4), 251.

Steckler, A. B., Linnan, L., & Israel, B. A. (2002). Process evaluation for public health interventions and research (pp. 1–23). San Francisco, CA: Jossey-Bass.

University of Kansas (n.d.). Community Tool Box. Part J. Evaluating Community Programs and Initiatives. Retrieved from: http://ctb.ku.edu/tools/en/tools_toc.htm#partJ

Wimbush, E., & Watson, J. (2000). An evaluation framework for health promotion: Theory, quality and effectiveness. Evaluation, 6(3), 301–321.