Global Psoriasis Coalition Launches Report on Primary Care Provision for Psoriasis & Psoriatic Arthritis

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On 23 September 2019, the President of the United Nations General Assembly convened a first-of-its-kind one-day high-level meeting on universal health coverage (UHC), a day before the start of the general debate of the Assembly at its 74th session. The United Nations defines UHC as “[ensuring] that all people and communities receive the quality health services they need, without financial hardship,” and emphasizes that primary health care is a core foundational element. This focus on a primary health care-driven approach to care provision echoes the World Health Organization’s recommendations for psoriasis care provision, as put forward in its 2016 Psoriasis Report. Unfortunately, health workforce shortages are persistent and present a major barrier to the effective care and management of all non-communicable diseases, including psoriasis and psoriatic arthritis. The WHO estimates a shortfall of 18 million health workers that must be filled in order to attain UHC commitments.

If the global community is to realize its commitments to universal health coverage (UHC) and to health and well-being for all, health systems will need to embrace new models of care delivery for diagnosing, treating, and managing patients living with chronic conditions. Psoriasis and psoriatic arthritis are representative of many chronic diseases in that they require long-term care, patient adherence to treatment, psychosocial support, and coordination across multidisciplinary care providers. Further, people living with psoriasis and psoriatic arthritis are at a higher risk of developing one or more additional NCDs, such as cardiovascular conditions and diabetes.

The systemic nature of psoriasis and psoriatic arthritis, coupled with their impact on mental health and links to other co-morbidities, mean that these conditions are particularly well-suited for diagnosis and, as appropriate, management in primary care settings. Further, a primary care-led approach to psoriasis and psoriatic arthritis management—wherein a specialist leads on disease treatment approaches, but a primary care provider ensures adequate consideration and management of comorbidities and facilitates linkages to social support—could serve as an instructive benchmark and point of reference in the development of similar care models for managing other chronic non-communicable diseases.

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On 24 September, the Global Psoriasis Coalition will officially release a report titled, “Beyond Gatekeeping: Effective Primary Care Support in the Management of Psoriasis & Psoriatic Arthritis” detailing practical and political recommendations for improving primary care support systems for people living with psoriasis and psoriatic arthritis. High-level recommendations include:

  • Embed increased education on all dermatological conditions, generally, and psoriasis, specifically, within training programs for primary care providers

  • Launch a special education campaign for primary care providers on the recognition of psoriatic arthritis

  • Enhance co-morbidity screening, behavior change, and care coordination efforts

  • Implement clear guidelines on when a referral to a specialist is necessary

  • Further explore of the management of psoriasis through a multidisciplinary primary care team approach

Access the full report here, on the Global Psoriasis Coalition’s website.

Cassie Waters