دورية أكاديمية
Analysis of Specialist and Patient Perspectives on Strategies to Improve Cardiovascular Disease Prevention Among Persons With Psoriatic Disease.
| العنوان: | Analysis of Specialist and Patient Perspectives on Strategies to Improve Cardiovascular Disease Prevention Among Persons With Psoriatic Disease. |
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| المؤلفون: | Barbieri JS; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts.; Review Editor, JAMA Dermatology., Beidas RS; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia.; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.; Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia.; Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia.; Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia.; Penn Medicine Nudge Unit, University of Pennsylvania Health System, Philadelphia., Gondo GC; National Psoriasis Foundation, Alexandria, Virginia., Fishman J; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia.; Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia.; Message Effects Lab at the Annenberg School for Communication, University of Pennsylvania Perelman School of Medicine, Philadelphia., Williams NJ; School of Social Work, Boise State University, Boise, Idaho., Armstrong AW; Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles.; Editorial Board Member, JAMA Dermatology., Ogdie AR; Department of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia., Mehta N; Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland., Gelfand JM; Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia. |
| المصدر: | JAMA dermatology [JAMA Dermatol] 2022 Mar 01; Vol. 158 (3), pp. 252-259. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Medical Association Country of Publication: United States NLM ID: 101589530 Publication Model: Print Cited Medium: Internet ISSN: 2168-6084 (Electronic) Linking ISSN: 21686068 NLM ISO Abbreviation: JAMA Dermatol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Chicago, IL : American Medical Association, [2013]- |
| مواضيع طبية MeSH: | Arthritis, Psoriatic*/drug therapy , Cardiovascular Diseases*/etiology , Cardiovascular Diseases*/prevention & control , Psoriasis*/diagnosis, Cholesterol ; Female ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires |
| مستخلص: | Importance: Patients 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 Measures: For 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 checked by their dermatologist/rheumatologist. Conclusions and Relevance: In this survey study, dermatologists and patients with psoriatic disease expressed positive perspectives about engaging in a specialist-led model of care to improve CVD prevention. Dermatologists appear to view several strategies as having potential to improve cardiovascular risk prevention. |
| التعليقات: | Comment in: JAMA Dermatol. 2022 Mar 1;158(3):239-241. (PMID: 35044422) |
| المشرفين على المادة: | 97C5T2UQ7J (Cholesterol) |
| تواريخ الأحداث: | Date Created: 20220119 Date Completed: 20220419 Latest Revision: 20230120 |
| رمز التحديث: | 20230120 |
| مُعرف محوري في PubMed: | PMC8771437 |
| DOI: | 10.1001/jamadermatol.2021.4467 |
| PMID: | 35044419 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2168-6084 |
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| DOI: | 10.1001/jamadermatol.2021.4467 |