Improving Outcomes in Plaque Psoriasis

Melodie Young, MSN, RN, ANP-C: All right, so is there any additional comment on that? Otherwise, if there’s anything else you would like to mention to your colleagues, I think all of us would say that we are here to help you. We love what we do. We love our profession, and we love having the opportunity to have such a tremendous impact on patients’ health. And working with these biologics, we want you to join in, have fun, and take care of people to the best of our ability. If you have questions, reach out to us. Every one of us on this panel would be glad to help you think through what would be best for a patient and encourage you to learn as much as you can. I’m an old lady. I’ve done this for a very long time. At every single conference, and every time I talk to a colleague or listen to a talk on psoriasis, I learn even more; and particularly more and more about the immunology associated with the disease.

At this point, it’s been wonderful. We need to provide our final thoughts. Margaret, is there anything else you want to say?

Margaret Bobonich, DNP, FNP-C, DCNP, FAANP: For our colleagues out there who manage patients with psoriasis, don’t be afraid of using biologics. That’s what many people will say. I’m more afraid of using cyclosporine, methotrexate. Remember, biologics are human DNA. We’ve grown them. They’re not new. The first biologic we started using was insulin, and look at how it changed health. As Melodie said, reach out to us and use it. Our role, as nurse practitioners [NPs] and PAs [physician assistants], and understanding how we can impact it from a holistic point—step in there. Get the education, get the training, reach out to us, and help change lives.

Melodie Young, MSN, RN, ANP-C: Douglas, any final thoughts?

Douglas DiRuggiero, PA-C: I want to echo the fact that this is an exciting time to be a prescriber, particularly with this disease state and other disease states that biologics are going to address. I get to be a hero in the office, and that’s just a great feeling. I didn’t develop these medicines. I didn’t bring them to market. I’m not responsible for the insurance companies, but I’m the face of all that. I’m the face of every IL-23 and IL-17 to that patient in my office. I get to sit there and put them on something, watch them clear, and have them hug me when they come in. It’s great to say, “Look, you get to be a hero and change someone’s life.” That’s why it’s worthwhile staying up to date and knowing about these medications and edging in on this if you haven’t used them before. Because you have the chance to be someone’s hero, and that is a great thing.

I mean, maybe the No. 1 hero you could be is the person finding a melanoma that someone didn’t know they had. That’s probably top of the list in dermatology. But I’m telling you, having someone get 90% clearance is a pretty darn close second in terms of impacting quality of their life, and that’s what makes it so great.

Melodie Young, MSN, RN, ANP-C: Yeah, the syringe can be the magic wand. It can. Any final thoughts, Melissa?

Melissa Davis, PA-C: Yeah. I would just say when you’re evaluating your patients, if you’re a primary care PA or NP listening to this, or in any other specialty besides dermatology, just remember if your patient has skin or joint issues, you may be the only person who catches their psoriasis. You can point them to us or to rheumatology colleagues. If you work in emergency medicine and you see somebody and you’re just interested in learning about dermatology and psoriasis today, remember that you don’t have to take care of them. Even in primary care, just send them for us to address their needs and treat them.

The other thing is, when you have a patient sitting in your exam room, just remember that they’re someone’s mom. They’re someone’s brother. They’re someone’s dad. Even on a busy day—sometimes I’ll have days where I get a little behind and I’m busy—I just think, “If this was my mom sitting in this exam room, how would I want someone to take care of her? How would I want someone to take care of my brother?” My mom or brother may not choose a systemic therapy for their psoriasis, but I would want my family member to know that they have the option. If you don’t feel comfortable treating them with a biologic or a systemic therapy, please send them to a colleague who does if that’s what the patient wants. Also, giving the patient all the information and empowering them to work with you to make a decision for their health is really important.

Melodie Young, MSN, RN, ANP-C: Do your best. Thank you.

Douglas DiRuggiero, PA-C: Thank you.

Margaret Bobonich, DNP, FNP-C, DCNP, FAANP: Thank you.

Melodie Young, MSN, RN, ANP-C: On behalf of our panel, we hope you found this Peer Exchange® to be useful and informative. Thank you.

Transcript edited for clarity.