Addressing Cardiovascular Risk in People With Psoriatic Disease Using a Care Coordinator Model: A Qualitative Analysis of a Pilot Study

Abstract

Background: Risk for cardiovascular events is elevated in people with psoriatic disease. Our team developed a care coordination model to assist in managing cardiovascular risk in people with psoriatic disease. We piloted this model and study procedures prior to launching a fully powered prospective clinical trial. Objective: This study used qualitative methods to gather feedback on the care coordinator model from constituents (clinicians, patients, and care coordinators) who participated in the pilot trial to optimize the approach. Methods: We conducted 42 total interviews with people with psoriatic disease, referring clinicians (dermatologists and rheumatologists), primary care providers, and care coordinators who participated in the pilot study. A rapid qualitative analysis approach was used. Results: Perceptions of the care coordinator model were highly positive. Participants noted that the model raised their awareness of cardiovascular risk in people with psoriatic disease. They found it easy to follow the recommendations provided by the care coordinator. Participants identified areas for improvement related to eligibility criteria, increased personalization of materials and goal-setting, and clarification regarding next steps and responsibilities for follow-up after patients concluded participation. Additional feedback highlighted concerns about the intervention content overly focusing on statin medication therapy. Conclusion: Constituent recommendations gleaned via interviews were incorporated into the care coordinator model and adjustments were made to trial procedures. Insights from these interviews may also be relevant to those seeking to close care gaps for identification and treatment of cardiovascular risk in people with psoriatic disease using other interventions.