Specialist-Led Model of Care Can Improve CVD Prevention in Psoriasis

Dermatologists and patients with psoriatic disease have a positive view of a specialist-led model of care to improve cardiovascular disease (CVD) prevention, according to a study published online Jan. 19 in JAMA Dermatology.

John S. Barbieri, M.D., from Brigham and Women's Hospital in Boston, and colleagues explored clinician and patient perspectives regarding strategies to improve CVD prevention via specialist-led care among patients with psoriasis. A best-worst scaling experimental survey study was conducted among dermatologists to rank the strategies according to their potential to improve CVD prevention. In addition, 160 patients with psoriasis and 162 with psoriatic disease were asked about seeing a specialist for CVD risk factors.

The researchers found that clinical decision support, patient education, and clinician education were ranked as strategies likely to improve CVD prevention in patients with psoriatic disease among 183 dermatologists (preference scores, 22.3, 14.1, and 15.8, respectively). Most dermatologists (69.3 percent) agreed or strongly agreed that checking lipid levels was feasible. Patients reported that the likelihood of engaging in cardiovascular risk screening and management behaviors was equivalent when recommended by primary care physicians or specialists. Overall, 60.0 and 75.3 percent of patients with psoriasis and psoriatic arthritis, respectively, agreed that it would be convenient for cholesterol to be checked by their dermatologist/rheumatologist.

"Moving the needle forward includes refining and developing modifiable CVD risk reduction strategies for patients with psoriasis, and collaboration between the fields of dermatology, rheumatology, and cardiology is key," write the authors of an accompanying editorial.