Among the challenges today in caring for those with psoriasis and psoriatic arthritis is the limited awareness of both conditions among non-rheumatologists. Even when psoriasis and psoriatic arthritis are recognized, there often exists a siloed approach to care, and a lack of communication. One of the problems with reduced cooperation between providers is that each specialty may have their own training and experience and therefore treat the problem through their own unique lens. This could lead to biased decision making or incomplete care for the individual living with psoriasis.
Dermatologists and rheumatologists unite
Quality care requires greater collaboration between dermatologists and rheumatologists. But how? One way to is to have combined dermatology-rheumatology clinics. According to a 2017 study published in Current Rheumatology Reports, there are already at least 20 such clinics that provide multidisciplinary care for those with psoriasis and psoriatic arthritis. Examples include the Rheumatic Skin Disease Clinic in Manhasset, New York; the Dermatology and Rheumatology Treatment Clinic at the University of British Columbia; and New York University’s Psoriasis and Psoriatic Arthritis Center.
The response is in: people benefit from combined clinics
A 2016 study published in Rheumatology International analyzed the efficacy and satisfaction of multidisciplinary dermatology-rheumatology management for those with moderate to severe psoriasis and psoriatic arthritis. Of the 506 patients who were considered in the study, 94 percent of the patients were “very satisfied” with a combined consultation model of care. The only negative issue found by the researchers was the waiting times on the day of the appointment at the combined clinics, which they suspected could be explained by the fact that joint decision making is slower.
Collaboration of care leads to more accurate diagnoses and treatment
Among the benefits of collaborative care are more accurate diagnoses and targeted treatment. The Brigham and Women’s Hospital in Boston has been operating the Center for Skin and Related Musculoskeletal Diseases for over a decade. A 2012 study published in the Archives of Dermatological Research examined the clinic experience of about 500 patients there. Results showed that visiting the center resulted in a revised diagnosis from that which was made outside the clinic in 46 percent of the cases. Patients were also more likely to receive a systemic medication after evaluation at the center and were more likely to be treated with a biologic agent.
Coming to your home?
Hopefully a combined dermatology-rheumatology clinic will be coming to your area soon. In the meantime, the positive results from these relatively small but powerful studies show the importance of building a multidisciplinary team to achieve the best care possible if you are living with psoriasis or psoriatic arthritis.