Prevention of cardiovascular disease and mortality in patients with psoriasis or psoriatic arthritis (CP3): Translating guidelines of care to better outcomes for patients with psoriatic disease
Principal Investigator: Joel Gelfand M.D., MSCE
Institution: University of Pennsylvania
Grant Mechanism: Psoriasis Prevention Initiative (Priority Mechanism)
Project Start Date: November 1, 2021
Project End Date: October 31, 2025
Keywords: Psoriasis, Psoriatic Arthritis, CVD Prevention, Patient Education
Psoriatic disease is associated with major medical comorbidity and mortality. Psoriasis patients requiring systemic agents or phototherapy die five years younger than expected and cardiovascular diseases (CVD) are the leading cause of their excess mortality. Guidelines from the AAD/NPF and the American Heart Association/American College of Cardiology target psoriasis patients for enhanced CV prevention efforts. Psoriasis is viewed as a CV risk enhancer warranting more aggressive screening for and management of traditional CV risk factors. A major practice gap is that despite the increased risk of CVD in people with psoriasis, they are more likely to have undiagnosed or inadequately managed CV risk factors. The NPF’s Strategic Plan seeks to increase the lifespan and health of individuals living with psoriatic disease. To achieve this goal, we propose to translate these guidelines to clinical practice by leveraging implementation science to shift screening of CV risk factors to specialists who mostly care for patients with psoriasis (rheumatologists and dermatologists). In year one of the PPI award we conducted a series of interviews and surveys of key stakeholders, including patients, dermatologists, and rheumatologists, to understand barriers and facilitators to implementation of CV prevention care in patients with psoriatic disease. The major findings from this engagement work are that patients and providers are highly motivated to address CV risk in the context of management of psoriatic disease and that a care coordination model is the most promising and preferred approach to improve the health and life span of patients with psoriatic disease so that their complex care needs can be optimally addressed. We will adapt and test this model through the innovative development of a centralized care coordination model embedded within the National Psoriasis Foundation patient navigator service in which the patients access this model through referral from their dermatologist or rheumatologist.
This grant was made possible in part by contributions from Stacey Butler and Chip Newton.
Joel M. Gelfand MD MSCE is the James J. Leyden Professor of Dermatology and Epidemiology (with tenure) at the University of Pennsylvania’s Perelman School of Medicine. He is also Vice Chair of Clinical Research, Medical Director of the Dermatology Clinical Studies Unit, and Director of the Psoriasis and Phototherapy Treatment Center. He is a nationally and internationally recognized expert in psoriasis, clinical epidemiology, drug safety, and clinical trials. Dr. Gelfand is the author of over 330 scientific publications, editorials, reviews, and textbook chapters (cited over 30,000 times, H index 90) which appear in journals such as JAMA, BMJ, European Heart Journal, Annals of Rheumatic Disease, JAMA Dermatology, JAAD, and the JID. He is a past Associate Editor of Pharmacoepidemiology and Drug Safety, past Editorial Board Member of the Journal of the American Academy of Dermatology, and is currently Deputy Editor of the Journal Investigative Dermatology. He is the recipient of the American Skin Association’s Psoriasis Achievement Award, PENN’s New Investigator Marjorie Bowman Award and the Lady Barbara Colyton’s Award for Autoimmune research, Penn’s Department of Biostatistics and Epidemiology’s epidemiology teaching award, National Psoriasis Foundation’s (NPF) inaugural award for scientific achievement, the American Dermatoepidemiology Network’s Founders award, and is an elected member of the American Society for Clinical Investigation. He Co-Chairs the NPF’s COVID-19 task force, and is a member of the Board of Directors for the International Psoriasis Council. He is a co-author of the AAD-NPF joint guidelines of care for psoriasis. He has given over 10 named lectureships and keynote addresses including the Society for Investigative Dermatology’s Eugene M. Farber lecture and the American Academy of Dermatology’s Marion B. Sulzberger lecture. He has received grant support from NIH, FDA, PCORI, the National Psoriasis Foundation, the Dermatology Foundation, the American Skin Association, and numerous pharmaceutical companies to support his independent research program. The overarching goal of his research and clinical practice is to improve psoriasis patient outcomes in the skin and joints, while lowering the risk of diabetes, CV disease, and mortality.