Ensuring Treatment Adherence and Compliance as Part of Optimal Patient Care in the Management of Psoriatic Arthritis - Episode 9
Before closing out their discussion on psoriatic arthritis management, two experts consider how the COVID-19 pandemic has affected their practice.
Michele M. Cerra, MSN, FNP-C: In the start of early 2020 we did things different at Duke in our practice because patients weren’t afraid to change therapies or start new therapies or even continue their therapy. How has the pandemic affected you as far as keeping patients on drug and compliant, starting new medications and seeing them in clinic, and then tell us about your mix of video, telemed [telemedicine] to in person visits?
Nancy Eisenberger, MSN, FNP-C: It’s been a challenging time. In the beginning, we had a lot of education for our patients to let them know that from the data we had from New York, places like NYU [New York University], Columbia, that it was safe to stay on medication. It was better to have inflammation controlled than your body trying to fight the disease and then trying to fight COVID-19. Once we got our patients educated enough on that fact, infusion went on as always. We didn’t miss a beat. If you weren’t coming in for an infusion, then we did a lot of video visits. They must come in at least every 6 months for a real appointment because you must touch patients. There’s no question. We can educate patients though and change medications on a video visit, I thought that was helpful. I’m glad that we had that option because it’s not safe to bring in people. Not everybody is vaccinated. With omicron especially patients are getting sick, even with 3 vaccines. We’re going to keep patients apart as much as possible, but patients are sticking with their medication because the data is out there, and we use evidence-based medicine and educate our patients and have good patients.
Michele M. Cerra, MSN, FNP-C: For the first 2 weeks of the pandemic, we were at home of course, just getting telemed [telemedicine] set up because we didn’t use it in our practice before the pandemic, which now I see was unfortunate. Once we got telemed running, I was 3 days in person in the office. We continued to see patients and they were coming in and then it was a wonderful day at home with telemed [telemedicine] up until June 1st, 2021. Duke [University] said, “OK, we’re all going back into clinic,” when we thought the numbers were going to go down and stay down. What I elected to do in June was I wanted to keep at least a half of day at clinic for my patients who are stable, and I could see them every 6 months in person but do some telemed [telemedicine]. Telemed [telemedicine] has become an important part of my practice and I will continue to utilize that. What percentage are you doing telemed [telemedicine] versus in-person visits?
Nancy Eisenberger, MSN, FNP-C: Currently, the only people I’m letting in the office are people who need an injection or are coming in for infusions. Everybody else, because the numbers have been terrible, we have been doing video visits or phone visits if they can do a video just for the protection of our infusion patients and our other immunocompromised patients.
Michele M. Cerra, MSN, FNP-C: I will say that our infusion suite has been busy since the beginning of the pandemic. We’re fortunate to have individual bays and private rooms where the door slides and they’re soundproof and patients don’t have to worry about sharing germs, but we are just so backed up, continue to be backed up with infusions. So patients really were not afraid to come in during the pandemic to get their infusion. The same for you that you’ve experienced, right?
Nancy Eisenberger, MSN, FNP-C: Yes. Once they were educated and knew that it was safer for them to be in control, we never missed a beat which is great. The only thing certain if somebody was getting a subq [subcutaneous injection] in the office we would go out to the car to make it more comfortable for a few of our medications that we use in psoriatic arthritis [PsA]. It’s a simple injection but other than that we try to keep patients as safe as possible. We don’t have the advantage of individual rooms. We have a big infusion suite. We had to decrease our number of chairs to give proper spacing, but we ran longer hours. We did everything we needed to do to make sure that everybody was accommodated.
Michele M. Cerra, MSN, FNP-C: Thank you for watching the HCPLive® Peers & Perspectives. If you’ve enjoyed the content, please subscribe to our newsletter to receive upcoming Peers and Perspectives and other great content right in your inbox.
Transcript edited for clarity.