406 Dermatologist and patient perspectives on implementing cardiovascular risk prevention in the management of psoriasis: A qualitative study

Gustafson, A.; Lieberman, Adina; Mason, Jennifer; Armstrong, Abigail; Ogdie, Alexis; Mehta, Nehal N.; Beidas, Rinad S.; Gelfand, Joel M.

doi:10.1016/j.jid.2021.02.429

Cited by 2 publications

(1 citation statement)

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“…Patients with psoriatic disease are at higher risk of CVD; however, care to address their risk factors is not adequately managed. Because many patients are not actively seeing a primary care physician and welcome management of their traditional cardiovascular risk factors in the context of their psoriatic disease evaluation, 32 a specialist-led model of care has the potential to improve CVD risk management in this population. In this survey study, both clinicians and patients expressed interest in such a model, particularly if it includes clinical decision support, patient education, and clinician educational outreach.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Specialist and Patient Perspectives on Strategies to Improve Cardiovascular Disease Prevention Among Persons With Psoriatic Disease

et al. 2022

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IMPORTANCEPatients with psoriatic disease are at increased risk of cardiovascular disease (CVD), which is a leading cause of mortality in this population. However, many of these patients do not have an active relationship with a primary care physician, and there may be a role for specialist-led care in prevention of CVD. OBJECTIVE To explore clinician and patient perspectives regarding strategies to improve CVD prevention via specialist-led care.DESIGN, SETTING, AND PARTICIPANTS Using electronically collected surveys, a best-worst scaling experimental survey study was conducted among dermatologists through the National Psoriasis Foundation as well as the American Academy of Dermatology from October 27, 2020, to April 1, 2021, to rank the strategies according to their potential to improve CVD prevention among patients with psoriatic disease. Participants were asked about the feasibility of specialist-led screening through an electronically delivered survey from the National Psoriasis Foundation conducted between February 1 and April 21, 2021. Patients with psoriatic disease were asked about whether they would like the specialist to screen for CVD risk factors. In addition, patients reported their likelihood to engage in CVD risk screening and management behaviors in scenarios in which either the primary care physician or specialist was making the recommendations. MAIN OUTCOMES AND MEASURESFor the clinician surveys, the primary outcome was the ratio scaled preference score (range, 0-100; higher is more preferred), as well as whether they think calculating a 10-year CVD risk score and prescribing statins seems feasible. For the patient surveys, the primary outcome was the likelihood to check cholesterol level, incorporate diet and exercise, or use statin therapy depending on whether recommended by the specialist or primary care physician, whether they would like their specialist to educate them about CVD risk, and whether they would find it convenient to have their cholesterol level checked by their specialist. RESULTS Among 183 dermatologists (102 [55.7%] women; mean [SD] age not collected), clinical decision support (preference score, 22.3; 95% CI, 20.7-24.0), patient education (preference score, 14.1; 95% CI, 12.5-15.7), and clinician education (preference score, 15.8; 95% CI, 14.3-17.3) were ranked as strategies likely to improve CVD prevention in patients with psoriatic disease. In addition, 69.3% (95% CI, 62.2%-76.0%) of dermatologists agreed or strongly agreed that checking lipid levels was feasible. Among 160 patients with psoriasis and 162 patients with psoriatic arthritis (226 [70.2%] women; mean [SD] age, 54 [13.3] years), patients reported they were as likely to engage in cardiovascular risk screening and management behaviors whether recommended by their primary care physician or their specialist. In addition, 60.0% (95% CI, 52.0%-67.7%) of patients with psoriasis and 75.3% (95% CI, 67.9%-81.7%) of those with psoriatic arthritis agreed that it would be convenient for them to have their cholesterol check...

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Section: Discussionmentioning

confidence: 99%