Specialist and Patient Perspectives on Strategies to Improve Cardiovascular Disease Prevention Among Persons Living with Psoriatic Disease.

Background: Psoriasis is an immune-mediated disease associated with excess risk for cardiovascular disease (CVD). Guidelines recognize psoriasis as a CVD risk enhancer; however, psoriasis patients often do not have CVD risk factors identified nor managed.
Objective: This study examines strategies to improve CVD prevention care from the perspective of dermatologists and patients with psoriasis.
Methods: Qualitative interviews were conducted using the Consolidated Framework for Implementation Research to examine the perspectives of physicians (N = 16) and patients with psoriatic disease (N = 16) on barriers/facilitators to CVD prevention. Interviews were transcribed and coded using an integrated approach designed to enhance reliability and validity using NVivo software.
Results: We found three major themes suggesting areas to target for the future: (1) Appropriateness: perceptions of whether CVD care should be deployed in this setting by both clinicians and patients, (2) Feasibility: whether CVD prevention care could be integrated into the current structure of specialist practice, and (3) Care Coordination: an interest by all parties to better integrate a team approach in CVD preventative care to reduce duplicative efforts, work practically in an already existing system rather than reinventing the wheel, and progress with the patients' best interests in mind.
Conclusions: These findings will inform the design of a clinical trial comparing the effectiveness of specialist clinician implementation of CVD guideline-based prevention care in patients with psoriasis. Ultimately, this study aims to increase the lifespan and health of patients living with psoriatic disease by decreasing barriers to their receiving appropriate CVD prevention care.
Competing Interests: Conflicts of Interest: The authors declare the following competing interests: Dr. Beidas receives royalties from Oxford University Press. She has provided consultation to the Camden Coalition of Healthcare Providers. She currently consults to United Behavioral Health and serves on the Clinical and Scientific Advisory Board for Optum Behavioral Health. She also sits on the advisory board for the AIM Youth Mental Health Foundation and the Klingenstein Third Generation Foundation. Dr. Armstrong has served as a research investigator and/or scientific advisor to AbbVie, ASLAN, BI, BMS, EPI, Incyte, Leo, UCB, Janssen, Lilly, Novartis, Ortho Dermatologics, Sun, Dermavant, Dermira, Sanofi, Regeneron, Pfizer, and Modmed. Dr. Ogdie has received honoraria for consulting for Abbvie, Amgen, BMS, Celgene, CorEvitas, Janssen, Gilead, Lilly, Novartis, Pfizer and UCB. Dr. Ogdie has also received grants to Penn from Abbvie, Novartis and Pfizer and to Forward Databank from Amgen. Dr. Mehta is a full time US government employee. Dr. Gelfand served as a consultant for Bristol-Myers Squibb, Boehringer Ingelheim, GlaxoSmithKline, Janssen Biologics, Novartis Corp, Regeneron, UCB (Data Safety and Monitoring Board), Sanofi, and Pfizer Inc, receiving honoraria; in addition, he receives research grants (to the Trustees of the University of Pennsylvania) from AbbVie, Janssen, Novartis Corp, Sanofi, Celgene, OrthoDermatologics, and Pfizer Inc