How to talk to your doctor about Treat to Target

| Steve Bieler
You may have read about Treat to Target, our treatment strategy that can help you achieve clear or almost clear skin. You may have decided to try it. If you have, that brings up a big question: How do you talk to your doctor about it?
 
We spoke with three prominent dermatologists to get some ideas for you.

1) Do your homework.

“Patients aren’t aware of all the options out there. Your doctor might not know all the options,” said Dr. April Armstrong, director of the psoriasis program in the Dermatology Dept. at the University of Southern California and a member of the NPF team that developed Treat to Target.
 
“Patients need to understand what are the benefits and what are the side effects of each medication. To be educated will be very helpful for the next time you visit your health care provider.”

2) Don’t overwhelm your health care provider.

Doctors want to help, but they’re busy people. How should you open this conversation? 
 
“I would advise patients to ask if their providers have heard of Treat to Target first,” Armstrong said. “If not, then the patient can talk about how they learned about these treatment goals. Tell your provider what these goals are, then ask where you, the patient, is in relation to these goals.
 
She cautioned against appearing confrontational. “Some providers who do not know about the goals may need time to read about them, digest them, and think about how these goals can be applied to their individual patients,” she said. 
 
“If they are initially unaware of these treatment targets, please do not act as if they should know them. Rather, ask them to visit the NPF site to read more about them. You can always come back to this issue at your next visit.”
 
Dr. Mark Lebwohl, Waldman Chair of Dermatology at the Icahn School of Medicine at Mount Sinai in New York, gave a presentation on Treat to Target at our National Volunteer Conference in Chicago on Aug. 5. He offered these sample questions:
  • How severe is my psoriasis?
  • What treatment options are appropriate for me?
  • What percentage of people will improve on this treatment?
  • How quickly can I expect improvement? 
  • What are the potential benefits and risks? What are the most common side effects?
  • Will I be tested regularly for side effects? If so, what kinds of tests and how often?
  • If I decide against this treatment, what are my other options?

3) Take your medicine.

“The tools we have today give us incredible results. They are highly effective and highly safe,” said Dr. Andrew Blauvelt, president and investigator, Oregon Medical Research Center of Portland, Oregon. “I call it a revolution.”
 
This may be a revolution, but here’s something that hasn’t changed: Adhering to your treatment or treatments. For example, if you have to administer your own shot, don’t put it off. Get trained in how to do it. Do you tend to forget your pills? Use pill boxes, apps or whatever it takes to stick to your schedule. Topicals are messy or inconvenient? Develop a daily routine to work them in. 
 
“The new drugs offer an incredible chance to be clear without side effects,” Blauvelt said. “They’re not a cure, though. You have to keep taking them.”

4) Be persistent! 

What you’re asking for – clear skin – might’ve been impossible years ago, but maybe not now. Blauvelt is an enthusiastic proponent of the new biologics, which target specific pathways of inflammation.
 
“Don’t be satisfied with residual disease,” he said. “Residual disease is residual inflammation in the body! If you’re not clear, ask your doctor about being clear. You should be talking.”
 
Bonus: Understanding your communication style might be the key to a successful discussion with your doctor! Take our quiz and receive resources from NPF to help you lead the conversation. 
 

Driving Discovery, Creating Community

This year, we’re celebrating 50 years of driving efforts to cure psoriatic disease and improve the lives of those affected. See how far we’ve come with this timeline of NPF’s history. But there’s still plenty to do, and we can’t do it without you! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funding to promote research into better treatments and a cure by joining Team NPF, where you can walk, run, cycle, play bingo or even create your own DIY event. Contact our Patient Navigation Center for free, personalized support for living a healthier life with psoriatic disease. And keep the National Psoriasis Foundation going strong by making a donation today! Together, we will find a cure.

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