Barriers and facilitators of co-management of PsA among dermatologists and rheumatologists

Psoriatic arthritis (PsA) is an inflammatory arthritis with potentially devastating outcomes and substantial impact on quality of life.  The diagnosis of PsA is often delayed and many patients with PsA are undertreated.  We hypothesize that improved partnerships between dermatologists and rheumatologists will expedite more accurate diagnosis of PsA and an earlier initiation of therapy.  The overarching goals of this proposal are to improve early identification of psoriatic arthritis in dermatology practices and enhance co-management among rheumatologists and dermatologists.  This proposal will employ qualitative methods (e.g., focus groups) to better understand early diagnosis of PsA and co-management from the perspectives of key stakeholders: patients, dermatologists and rheumatologists. An educational and networking intervention will be delivered as a part of the study to improve screening and foster collaborations and a derm-rheum collaborative care toolkit will be developed and provided as a part of this intervention.  Follow up surveys will be conducted to evaluate the effectiveness of the intervention. The partnering organizations include the Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network (PPACMAN) and International Dermatology Outcome Measures (IDEOM). The mission of PPACMAN in North America is to nucleate PsC/PsA combined clinics and centers to advance a multi-level approach to psoriatic patients, increase disease awareness and accelerate management.  Finally, IDEOM seeks to bring together physicians, researchers, government agencies, pharmaceutical companies, payers and patients from around the globe to develop and validate measures throughout the field of dermatology with an initial focus on psoriasis.