Dermatologist Preferences for Strategies to Improve Statin Use in Psoriasis Patients
Dr. John Barbieri is a dermatologist and postdoctoral research fellow at the University of Pennsylvania. His research mentors are Dr. Joel Gelfand and Dr. David Margolis. His interests include acne, antibiotic stewardship, patient reported outcomes, and delivering high-value care.
Patients with psoriasis are at increased risk of cardiovascular (CV) disease, but are less likely to have high cholesterol identified and treated. Since many patients with psoriasis do not routinely see primary care, involving dermatologists to screen for cholesterol and potentially prescribe statins has promise to improve outcomes.
To evaluate dermatologist preferences for strategies to improve statin use among psoriasis patients, a survey consisting of a best-worst scaling choice experiment of 8 implementation strategies and items on willingness to screen and manage CV risk factors was fielded among dermatologists recruited through the National Psoriasis Foundation from Oct-Dec 2020. Ratio-scaled preference scores for each strategy were generated using hierarchical Bayes analysis in Lighthouse Studio.
In these preliminary results among 69 dermatologists, 44% were male and 25% practiced in an academic setting. Overall, 64% agreed that checking a lipid panel and calculating a CV risk score seems doable and 32% agreed that prescribing statins seems doable. Additionally, 68% agreed that they would consider changing their practice if a trial demonstrated that psoriasis patients achieved better CV prevention when their dermatologists screened for high cholesterol and prescribed statins. In the best-worst scaling experiment, the highest ranked strategies included clinical decision support (preference score, 23.2), patient educational materials (15.7), and physician educational outreach (15.4).
Our results highlight that dermatologists are willing to consider lipid screening and prescribing statins in psoriasis patients. These findings will guide the design of a future trial to evaluate strategies to improve lipid screening and statin use among psoriasis patients.
KeywordsPsoriasis; Cardiovascular Disease; Dermatology; Implementation Science; Best-worst scaling; Survey; Preferences
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