Psoriasis and Mental Health: Why Digital Therapeutics Should Be In Your Care Plan

Psound Bytes™ Transcript: Episode 165

Release date: May 10, 2022

“Welcome to this episode of Psound Bytes, a podcast series produced by the National Psoriasis Foundation, the nation’s leading organization for individuals living with psoriasis and psoriatic arthritis. In each episode someone who lives with psoriatic disease, a loved one or an expert will share insights with you on living well. If you like what you hear today, please subscribe to our podcast and join us every month at Psound Bytes for more insights on understanding, managing, and thriving with psoriasis and psoriatic arthritis.”

SHIVA: My name is Shiva Mozaffarian and today’s episode sponsored by Happify Health addresses “Psoriasis and Mental Health: Why Digital Therapeutics Should Be In Your Care Plan.” This episode is being offered as a way for you to hear directly from Happify Health and may contain information about a Happify Health offered product. From time to time, NPF shares sponsored content that we think is of benefit to those with psoriatic disease. NPF encourages everyone living with psoriatic disease to work with their health care provider to find an appropriate treatment for them. NPF does not offer medical advice and this podcast should not be considered an endorsement of any particular product or treatment. I’m here today with Theo Ahadome, Senior Vice President of Commercialization at Happify Health.

Welcome Theo! Thank you for being on Psound Bytes™ today. Let’s start by letting our audience know who is Happify Health and why do you exist?

THEO: Shiva, thanks for having me. Very excited to be here. The simplest way I think I can answer that is to say today in healthcare, there really is not any effective way to treat the mind and the body together holistically, right. And we know from ample research that the person with chronic health problems will have significantly higher healthcare costs if they develop mental health problems as well, such as anxiety and depression. And we know for psoriasis in particular these severity of symptoms is actually exacerbated by anxiety and depression. Right, so it's bidirectional. So what we've built at Happify Health is a way to try to solve that problem. It's a platform that surrounds people with digital care and allows them to connect to the right resources, mind and body to ultimately improve their health and psoriasis related outcomes.

One in five Americans today have unrecognized symptoms of depression. That means they've taken a clinical assessment and they're exhibiting symptoms of severe to mild depression. But that's not how they interpreted it or they've not been diagnosed as such. They think they're just tired. They often think it's a way of life. And because  they don't recognize these symptoms, they’ll also never really directly ask for help and if you're not seeking the help, then direct healthcare costs are something like 2 1/2 times higher than for someone else who is not depressed. This is data that we've published as Happify. So that's a huge problem there that we're trying to solve. In the case of a person with psoriasis, the value of what we do is to get people into this online community called Kopa that we've partnered with the NPF to build and help them directly address their mental health issues related to psoriasis, help them better navigate their care as it relates to overall psoriasis, give them the tools and resources they need to better manage living with psoriasis holistically. And also get them assessed and directed to one of our digital therapeutics that takes them on a therapeutic journey to help improve things like anxiety and depression that they face as they're going through psoriasis. So to summarize, we are a community platform for psoriasis called Kopa. We have early assessment and triage and personalization through our wellness and digital therapeutics. As well as really providing care delivery through coaching, telehealth and other services that we provide as Happify.

SHIVA: Thank you so much for that introduction to Happify Health Theo. So I'm curious, how did Happify Health partner with the National Psoriasis Foundation in the first place?

THEO: All of our Kopa communities, including Kopa for Psoriasis, essentially bring people together. Bring healthcare professionals together, bring patients together, bring digital therapeutics together to essentially help people live better lives.  And for psoriasis, it's helping you to manage psoriasis or psoriatic arthritis overall. And that really ties in with the NPF's goals as well. So the NPF we partnered with in 2021 where Kopa for Psoriasis became the official online community for the NPF. Today, we have more than 65,000 people living with psoriasis and psoriatic arthritis who are able to access the tools and resources that we provide as Kopa, and many of those are NPF members and we look to continue to grow that number over time.

SHIVA: Absolutely. And why is psoriasis important for Happify Health?

THEO:  Yeah, psoriasis is one that in some ways, it's not as widely known as maybe some other conditions, but it's one that affects 125 million people across the globe. 7.5 million adults in the US alone have psoriasis. And in addition to being painful and difficult to deal with, it's also really expensive. The annual cost of psoriasis is something like $100 billion in the US and of that, something like 36 billion is spent on comorbidities associated with immune mediated disease.  So, that's where we come in, especially on the comorbidities side of things to help drive that cost down. I believe we have a huge opportunity to improve people's lives as well as reduce healthcare costs through early detection, diagnosis and support.

SHIVA: So earlier you mentioned mental health. Let's talk a bit about the connection between chronic conditions like psoriasis and psoriatic arthritis and mental health. Is there one?

THEO: Absolutely. High levels of distress are associated with psoriasis that can negatively impact mental health, especially when psoriasis patches are visible. Recent research that  that we've done found that 20% of psoriasis patients had at least mild depressive symptoms, 14% had at least moderate depressive symptoms and over 30% had at least mild anxiety, and 20% had at least moderate anxiety. The data is very clear that psoriasis is an area that has outsized proportions of people with mental health challenges. And of course, in addition to the physical comorbidities associated with psoriasis, so there’s psoriatic arthritis, chronic pulmonary disease, diabetes, also some other comorbidities that one has to deal with on top of the mental health challenges. So it's important for us to recognize the mental and emotional toll that this takes on folks living with this condition, even just beyond the physical aspects.

SHIVA: So when it comes to digital therapeutics, as it applies to chronic conditions such as you just mentioned and like psoriasis and psoriatic arthritis, what is Happify’s role?

THEO: So digital interventions, like, what we provide at Happify with our Kopa community essentially can help support those with psoriasis, improve their overall wellbeing, help them navigate their care better and provide the right resources and tools that ultimately helps improve their disease. So for us, we do this by creating a safe and supportive space for folks living with psoriasis to be able to connect to each other and connect to the tools and resources, including healthcare professionals that we have. And again a very safe and inclusive place,  also a very scientifically validated place. So everything we have and everything that people learn on our platform is scientifically valid to help them better manage their disease.

SHIVA: And can you be more specific about what patients experience in Kopa for Psoriasis? For example how does Happify Health bridge the gap between people managing psoriasis and the many treatment options that are available?

THEO: Yeah, one thing that we do really well is as you come into the platform, we essentially help understand where you are in your psoriasis journey. Have you recently been diagnosed? How long have you been diagnosed? What type of psoriasis do you have? What level of severity of psoriasis do you have? What type of medications are you taking today? Are they working, are they not working? So that we can really personalize from there your experience and your experience comes in a number of ways. Connections that we make between you and other patients that have similar profiles to you that may have gone through similar journeys and can help support you. Connections that we provide then to healthcare professionals on the platform dermatologists, but not just dermatologists, nutritionist, dieticians who can also help as you have challenges around diet and nutrition and just overall living with psoriasis. We also provide various tools such as symptom trackers to help you evaluate where you are overtime, both from a pure psoriasis perspective as well as from a mental health and stress perspective as well. We believe that both prescription and non-prescription digital care that meets clinical standards can help manage a condition like psoriasis. So in many cases we’re providing the non-prescription digital care and we're also helping connect those patients to various treatment options and prescription options that are right for you based on where you are. This overall personalized approach is what we call intelligence healing. It's kind of where efficacy meets empathy and you get the best results for that patient.

SHIVA: Sounds like a wonderful tool to use. Has Happify Health research revealed any specific challenges to living with psoriasis and psoriatic arthritis? What's your community telling you?

THEO: Yeah, we listen to our community and continue to provide resources to them based on what they're telling us and we learn a lot. So some of what we are hearing from our members is one is what we mentioned earlier around the emotional burden. We see that in research, but our users tell us that very directly as well that psoriasis comes with a large emotional burden. One of the most challenging aspects of dealing with psoriasis that they tell us about is actually the emotional and mental impact of flare ups. Users say the biggest challenge they find when seeking emotional support is that they feel as if people who don't have psoriasis don't get it right. It's not well understood why psoriasis is sort of affecting your mental health and your emotional wellbeing. Additionally, what they tell us is choosing the right treatment is extremely hard, right?  Our Kopa Member surveys found that 41% of members say the biggest challenge that they face was finding the right treatment options. There are myriad of choices for managing and treating psoriasis. From creams and topicals all the way through to biologics, injectables. They often switch treatments, they have multiple treatments, and they go on multiple treatments before they find the one that works for them. So it's hard navigating the treatment landscape. 

SHIVA:  That’s so true and NPF hears that a lot too. What else have you heard from the Kopa community?

THEO: I mentioned we have dietitians and nutritionists on the platform and that's because one of the areas that members are keenly aware of that impacts their psoriasis and they tell us about is diet. 91% of our users believe diet impacts their psoriasis. However only something like 12% said that their doctor recommended dietary changes or that they're speaking to the doctor about dietary changes at all. So that's a huge gap between 90 and 12. 95% plus have not even seen a nutritionist. So there's also some gaps there that we try to fill. The top foods that members think on the diet side that help their psoriasis are fruit and vegetables, gluten free foods, dairy free diets. But we all know with any diet it's not one size fits all. So just trying to even navigate what type of diet works best for your psoriasis is something that they find challenging.  A couple other things. There's a lot. I could go on forever about what we learned. Kopa encourages members to see their doctor and to see a dermatologist.  A member survey found that initially, a lot of our members are not something like a third are not always seeking a professional. But what we’re gonna do is try to increase that through education on why you should go out and see an HCP who can better diagnose and treat your psoriasis and we've seen improvement something like 30-37% improvement over a couple of months in the numbers of people who are actually going out and seeking treatment. And then finally, Kopa is helping people make the right treatment decisions as well.  A survey of our users showed that something like 14% of users switched their psoriasis medication after joining Kopa.  And almost 20% of those, 10% said an article or video on Kopa was the reason they switched. Another 10% credited that to interactions with Kopa experts. So we're not there to recommend one product over the other, but those interactions that they have are helping them better navigate what treatments are best for them and they're getting on the right treatment as a result of those interactions.

SHIVA: The data you shared from Kopa members is so interesting. Using digital therapeutics might be new for a lot of people. I’m curious, has Happify Health run any studies that show digital therapeutics can help people with psoriasis?

THEO:  Yes, for sure. We conducted a study recently that explored just that. I mean what we saw was after people with psoriasis or psoriatic arthritis completed about 16 activities on Happify within a couple of weeks they were able to reduce their anxiety levels by something like 26% and increase their overall wellbeing by 27%.  And these are psoriasis and psoriatic arthritis patients. So we're able to see improvements by using Happify in terms of their mental wellbeing.

SHIVA:  That’s amazing! So what features in Kopa for Psoriasis are you most proud of?

THEO: Ah that's a hard question. There are various things.  The first I would say is we're thrilled about the informational articles and personalized content that we're able to provide. So we post medically reviewed articles on a weekly basis, a number of different articles every single week.  And stay up to date regarding treatment options regarding how to deal with flare ups, diet and exercise and and other topics.  Our content theory just helps members handle symptoms of psoriasis and psoriatic arthritis. And It's really the sort of the foundation of the platform in terms of helping people provide a set of valid information and resources that is specific to them. Next is the symptom tracker. So we know it's a challenge to always know what's going on with your body and communicate that appropriately to your doctor.  So we created an interactive tool that helps members track their flare ups and other symptoms on a daily, weekly, monthly basis. They can indicate the percentage of your body that's affected, specific areas that are not and be able to drop those down and have that tracker with them so that when they do go to their doctor they can have more informed conversations. And the doctor is able to see if they want to share with their doctor data on their journey has been in between those doctor visits. We also have a tool that helps you track your stress levels so that you can see over time how you're improving on stress levels as you interact with the platform. Finally, we're, we're very proud of our experts. I mentioned dermatologists, board certified medical experts in derm and other fields that share the latest news, health news and treatment breakthroughs. Dr. Joel Gelfand, who's an NPF advisor and expert, also serves as an expert on Kopa. And It's really important for us that we'll be able to provide our members, our users with access to these leading experts and providers in the psoriasis field, and then what really underpins everything is the community support. So when you become a corporate member, you have a vibrant community of other Kopa members, other psoriasis patients at your fingertips where you’re able to share your concerns and challenges with others who know exactly what you're going through because they've been there themselves.

SHIVA: You mentioned the Kopa community.  How has the Kopa platform expanded?

THEO:  Yeah, we continue to launch new communities over time. So we've recently launched a number of communities. One is Kopa for women in midlife that is really designed to help navigate midlife and menopause.  Fun fact about 3000 people in our women and midwife community actually came from our psoriasis community. We also recently launched a Kopa for pregnancy that helps you safely and confidently sort of navigate your pregnancy journey.  And then we've launched as well a Kopa for multiple sclerosis that's about supporting and informing people living with Ms.

SHIVA: Those are all great and relative areas to expand into. So what's new for the Happify Health and NPF partnership?

THEO:  Yeah, we're always working together to provide new insights and value to the psoriasis and psoriatic arthritis communities. Through things like doing research together, the number of collaborations and events that we're doing together this spring and this summer. We participate in upcoming Team NPF events such as the cycle or walk events to further connect with others managing their community. And we can continue to listen to our community. You, The NPF continues to listen to their community and the idea is to stay connected between the two organizations to continue to find ways to provide value. So a lot to come. We love the partnership and we look forward to continue to evolve it.

SHIVA: Well it certainly sounds like Kopa for Psoriasis is where people can go to learn more and take action. So in closing, Theo can you please recap some of the benefits of Kopa for our listeners?

THEO:  Absolutely. So as a member of Kopa for Psoriasis, you can share your concerns and challenges with others who know exactly what you're going through. You can get personalized content to your life stage, symptoms and interests, all designed to help you manage your physical wellness, mental health and relationships. You can track your symptoms with interactive tools and games that allow you to improve your stress levels and care for your mental health as well. And overall you can take control of  your health and help improve your overall health outcomes. So please go to Kopa.com and check it out.

SHIVA: Thank you Theo for sharing such an invaluable resource for the psoriasis and psoriatic arthritis community. In addition to Psoriatic Arthritis Action Month, May is Mental Health Awareness Month. Take advantage of the tools available through Kopa for Psoriasis to help you not only manage your psoriatic disease but also your emotional health. Visit kopa.com today. 

We hope you enjoyed this episode of Psound Bytes for people with psoriasis and psoriatic arthritis. If you or someone you love has ever struggled with psoriatic disease, our hope is that through this series you’ll gain information to help you lead a healthier life and inspire you to look to the future. Please join us for another inspiring podcast. You can find this or all future episodes of Psound Bytes on Apple Podcasts, Spotify, iHeart Radio, Google Play, Gaana, and the National Psoriasis Foundation web page. To learn more about this topic or others please visit psoriasis.org or contact us with your questions or comments by email at podcast@psoriasis.org.  

This transcript has been created by a computer and edited by an NPF Volunteer.

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