Telemedicine, psoriatic arthritis and loneliness

David VK Chao 周偉強

HK Pract 2025;47:30-31

Welcome to another edition of the Hong Kong Practitioner, the official journal of the Hong Kong College of Family Physicians. In this issue, we have selected for you one original article on telemedicine by C Y Yan, a case report on psoriatic arthritis by P K Chan et al, and a discussion paper on loneliness by Y T Tong et al.

Telemedicine has made tremendous progress in recent years as an alternative means for providing consultation. And it has been used frequently around the world especially in primary care settings during the COVID-19 pandemic years as telemedicine can help to maintain healthcare access and preserve social isolation at the same time. In this issue of the Hong Kong Practitioner, a qualitative study employing individual face-to-face semi-structured interviews has been reported to explore the barriers and facilitators to the implementation of teleconsultation as perceived by family doctors working in the public sector. According to the author, there were five key themes identified, including patients' reasons for consultation, patients' competence in using teleconsultation, doctors' personal consideration, infrastructure, and last but not least medicolegal consideration. The author suggested that by overcoming the underlying barriers and facilitators, the local implementation of teleconsultation can be accelerated to fulfill the service gaps.

Psoriatic arthritis could present with polyarthritis without a history of psoriasis. The authors reported the background information on psoriatic arthritis and described the common presentations of psoriatic arthritis. They went on to discuss a young adult male patient presented with polyarthritis without obvious psoriatic skin lesions. The drug treatment regimes including the use of Disease Modifying Anti-Rheumatic Drugs (DMARDS) and tissue necrosis factor (TNF) inhibitor have been discussed in details, making the article even more informative. There are clear and illustrative clinical photos demonstrating the relevant physical signs being discussed. This article reiterates the importance of having a systematic approach in the diagnosis of patients presenting with polyarthritis.

Loneliness can seriously affect people's physical and psychological health. The authors discuss the risk factors that would predispose people to loneliness, the sequelae that can follow and the strategies to deal with loneliness once it has occurred. The role of family doctors in helping patients affected by loneliness has also been discussed.

We have also got the regular clinical quiz section and the internet section. The clinical quiz section is on a lady who has been newly diagnosed to have diabetes mellitus and presenting with itchy papules and nodules on the legs. While the internet section is focusing on transforming healthcare for the aging population.

Wish you an enjoyable read!