are we - psoriasis...2018/01/03  · feldman sr. j drugs dermatol 2010;9:908 911 summary (1)...

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WHERE ARE WE TODAY? Professor Dr med Ulrich Mrowietz

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Page 1: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

WHERE ARE WE TODAY?

Professor Dr med Ulrich Mrowietz

Page 2: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

◦ HCPs who already have a patient empowering approach to treatment

◦ HCPs who will take responsibility in rolling out the implementation of different tools and programs to improve patient adherence and outcomes nationally

◦ HCPs who are collaborative, contributing and forward-thinking

◦ HCPs who can communicate in English

Professionals who not only get inspired

but who are willing to make a difference

Academy participant profile

Page 3: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

Key objectives of the Academy

◦ Support implementation of patient empowerment in daily clinical practice

◦ Disseminate tools or interventions that will help improve patient adherence (and thus patient outcomes) without increasing overall time and cost per patient

◦ Support improvement of HCP and patient communication

◦ Build a platform for a continuous communication loop with participants through interactions and support

To enhance adherence and real-life outcomes for people living with psoriasis

Page 4: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

Communication is key

◦ How we communicate information to patients about their disease and treatments is key to improving adherence:

◦ The Psoriasis Academy aims to equip you to teach others about communication strategies that improve adherence

◦ The Academy will offer training, resources and processes that support HCPs to empower their patients to take control of their condition

Informed and engaged patients stand a better

chance of managing their

psoriasis effectively

Patients can be empowered through interaction and communication

with their HCP

Page 5: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

Identifying specific adherence challenges

Research identified four basic patient types in psoriasis

Self-manager Actively engaged

Why me? Help me

40% 16%

28% 16%

Based on insights from Bewley et al. J Eur Acad Dermatol Venereol 2014;28:763–770

Page 6: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

Understanding these patient types may benefit HCP–patient communication

◦ Grouping patients according to key behaviours and characteristics will support HCPs in their engagement with patients, helping them to:

• Refer patients as necessary for psychological assessment/therapy

• Provide empathy, emotional support and educational resources

• To use medication more efficiently

Page 7: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

Understanding these patient types may benefit HCP–patient communication

◦ Research indicates that patients belonging to the ‘Why me’ and ‘Help me’ profile types*:

• May have a more negative relationship with their HCP

• Tend to be the least satisfied with topical treatments (due to onset of action, and fear of side effects)

• ‘Help me’ profile may have more concomitant conditions and have a greater propensity to anxiety, depression, insomnia and arthritis

*Based on research insights (5+ years, ~6000 patients), data for 1884 of these patients published in Bewley et al. J Eur Acad Dermatol Venereol 2014;28:763–770

Page 8: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

Understanding these patient types may benefit HCP–patient communication

◦ A good HCP–patient relationship and inclusion of patients in therapy decisions (joint planning approach) may help to improve treatment adherence and patient satisfaction1,2

◦ This requires sufficient time at each visit to explain the use, benefits and possible side effects of medications

1. Augustin et al. Dermatology 2011;222:363−374; 2. Umar et al. J Eur Acad Dermatol Venereol 2013;27:763−770

Page 9: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

HCP–patient interactionsExpectations/understanding influence treatment adherence

Differences in HCP and patient expectations/ understanding are:

o Treatment goals

o Need for education

o Content and quality of first visit

o Importance of maintenance treatment

Uhlenhake et al. J Dermatolog Treat 2010;21:6–12

Page 10: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

HCP–patient interactionsExpectations/understanding influence treatment adherence

Improving the HCP–patient relationship can improve medication adherence:1,2

o A patient’s trust in a HCP is linked with effective

communication

o Trust can be increased if HCPs:

• Show patients they understand the burden of their illness

• Listen to patients’ concerns

• Physically examine patients’ skin

1. Feldman et al. J Am Acad Dermatol 2008;59:1009–1016; 2. Feldman SR. J Drugs Dermatol 2010;9:908–911

Page 11: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

Summary (1)

◦ Treatment adherence is recognised as a specific challenge to the effective treatment of inflammatory skin conditions such as psoriasis

◦ Non-adherence to treatment is associated with poor clinical outcomes, may foster inappropriate therapeutic decisions and can result in increased healthcare costs

Page 12: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

Summary (2)

◦ There are many reasons for patients not adhering to treatment, both intentional and non-intentional:

Social and economic

HCP and system related

Disease related

Treatment related

Patient related

Page 13: ARE WE - Psoriasis...2018/01/03  · Feldman SR. J Drugs Dermatol 2010;9:908 911 Summary (1) Treatment adherence is recognised as a specific challenge to the effective treatment of

National roll-outs

Delegates from 29 countries attended

the 3 regional Academies

Most countries have held or are planning

their faculty meetings

>20 countries have held national academy

workshops

Reaching over 1600 healthcare

professionals