Transcript
Announcer:
Welcome to DermConsult on ReachMD. Today, we’ll hear from Dr. Amylynne Frankel, who’s a board-certified dermatologist at Advanced Dermatology and Cosmetic Surgery in Spartanburg, South Carolina. She’ll be discussing barriers to psoriasis treatment and strategies for overcoming them. Here’s Dr. Frankel now.
Dr. Frankel:
In this day and age, nothing is covered, so we've had to change the way that we do follow-up. When I start a patient on a medication after we've decided what we're going to do, initially, I will give them a sample, and I will—depending on the dosing for that drug—have them come back when they're due for their next drug. Whether it's a shot or a pill or anything, I'll have them come back just to make sure that the insurance company has approved the drug. If they haven't, then I'm going to have to give them another shot if I have a sample, even if I don't think that it is soon enough to see if it's working.
I think patient buy-in is important for the speed of efficacy, but also just getting the drugs. And communication is really important. The insurance companies have made it very difficult for us to actually get treatments to our patients—really difficult. And so patients don't understand why they're not getting drugs. They often blame the doctor. It's not the doctor; it's the insurance companies. And so it's important to have close follow-up, because if the patients don't get their drugs, oftentimes they'll come back at three or four months and say, "Well, I never got the drug after that first shot that I got in the office." And you never want to see that happen, because that delays their care.
There's no cure for psoriasis. You have to treat. There are some super responders that may be lucky enough to go into a remission for an extended amount of time, but there is no such thing as a cure for psoriasis as of yet. And so they need buy-in to know that they can't just stop treatment, especially if they have systemic disease. And I often do talk to my patients about the fact that psoriasis is not just the skin, and it's not just the joints. When you have bad inflammation on the skin, it means you have bad inflammation in your body, and that increases your risk for cardiovascular comorbidities.
And so if I have a patient who I think should be on a systemic medication and they're a little bit hesitant, I do talk to them about the fact that treating the systemic inflammation will help them overall in their whole life. And so again, educating the patients on what exactly psoriasis is and what it means, not just to their skin, but to their overall health, I think helps with better patient buy-in.
Announcer:
That was Dr. Amylynne Frankel talking about how to set psoriasis patients up for treatment success. To access this and other episodes in our series, visit DermConsult on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
