Call to action. Dr Anthony Bewley

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1 Call to action Dr Anthony Bewley

2 Dr Masatoshi Abe Sapporo Skin Clinic Sapporo, Japan Professor Xibao Zhang Guangzhou Institute of Dermatology Guangzhou, China National roll-out experience Professor Sameer Zimmo King Abdulaziz University Jeddah, Saudi Arabia

3 National roll-out experience in Japan Masatoshi Abe Sapporo Skin Clinic

Global and Japanese Psoriasis academy Prof.

Masatoshi Abe Psoriasis academy 2015 in Dubai

Koki Endo Japanese faculty members Psoriasis

4 Global and Japanese Psoriasis academy Prof. Ohtsuki joined global faculty group from April Japanese attendees Prof. Mamitaro Ohtsuki Dr. Masatoshi Abe Psoriasis academy 2015 in Dubai 1 st Japanese Psoriasis Japanese attendees academy 2016 Prof. Mamitaro Ohtsuki Dr. Masatoshi Abe Dr. Koki Endo Prof. Mamitaro Ohtsuki Dr. Masatoshi Abe Dr. Koki Endo Japanese faculty members Psoriasis academy 2016 world summit in Frankfurt 2 nd Japanese Psoriasis academy 2017 Prof. Mamitaro Ohtsuki Dr. Masatoshi Abe Dr. Koki Endo Prof. Yayoi Tada Japanese faculty members

5 Japanese Psoriasis academy 2016

6 2016 Faculty Member Prof. Mamitaro Ohtsuki Professor, Department of Dermatology, Jichi Medical University Dr. Masatoshi Abe Deputy Director, Sapporo Skin Clinic Dr. Koki Endo Lecturer, Department of Dermatology, Iwate Medical University

Collaborate with The 31 st Annual Meeting of the Japanese Society for Psoriasis Research Date: September 3, 2016 (Sat) 16:00 to 18:10 Theme: Let's know well the psoriasis patient!

7 Collaborate with The 31 st Annual Meeting of the Japanese Society for Psoriasis Research Date: September 3, 2016 (Sat) 16:00 to 18:10 Theme: Let's know well the psoriasis patient! Let s learn the skills to improve the daily practice Agenda: Time Contents Speaker 16:00-16:05 5 min Opening Remarks Prof. Ohtsuki 16:05-16:35 30 min Introduction & Key Note Lecture Let s know well the psoriasis patient! Dr. Abe 16:35-16:50 15 min Explanation of Case Study Dr. Abe & Dr. Endo 16:50-18:05 75 min Case Study 1Group work & Discussion 2Explanation & Sharing of the entire Dr. Abe & Dr. Endo 18:05-18:10 5 min Wrap Up Prof. Ohtsuki

8 Roll-out 40 dermatologists participated Demonstrated 4 patient's profiles each 5 minutes each by faculty members Discussed about these patients in each group (7 tables) Presented the result of the table discussion by group facilitator.

9 Japanese Psoriasis academy 2017

10 2017 Faculty Member Prof. Mamitaro Ohtsuki Dr. Masatoshi Abe Dr. Koki Endo Prof. Yayoi Tada Professor, Department of Dermatology, Jichi Medical University Deputy Director, Sapporo Skin Clinic Lecturer, Department of Dermatology, Iwate Medical University Professor, Department of Dermatology, Teikyo University School of Medicine

Collaborate with The 32 nd Annual Meeting of the Japanese Society for Psoriasis Research Date: September 9, 2017 (Sat) 16:10 to 18:20 Theme: Let's know well the psoriasis patient!

11 Collaborate with The 32 nd Annual Meeting of the Japanese Society for Psoriasis Research Date: September 9, 2017 (Sat) 16:10 to 18:20 Theme: Let's know well the psoriasis patient! Let s learn the skills to improve the daily practice Agenda: Time Contents Speaker 16:00-16:15 5 min Opening Remarks Prof. Ohtsuki 16:15-16:35 15 min Introduction & Key Note Lecture Prof. Tada 16:35-16:45 10 min Case study -Demonstration Faculty members 16:45-17:55 70 min Case Study 1, 2 (VTR) 1Activity Engaged Preferred/Not preferred 2Help me VTR: Dr. Abe Facilitate: Dr. Endo 17:55-18:15 20 min Output - Role Play - Facilitate: Dr. Endo (Patient s roll: Dr. Abe) 18:15-18:20 5 min Wrap Up Prof. Ohtsuki

12 Roll-out 32 dermatologists participated Observed 3 cases VTR (Japan ver.) & table discussion in each group (7 tables) 1 case Activity engaged patient, unfavorable communication case 2 case Activity engaged patient, good communication case 3 case Help me patient 2 selected participants played role of preferred doctor on stage Japan ver. VTR

13 Japan version VTR

14 Feedback from participants Results of participant's questionnaire

15 Feedback from participants Q1 How satisfied were you with the contents of the seminar? ,5% 25,8% % 40% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied Somewhat dissatisfied Very dissatisfied No comment Q2 How well did you understand the characteristics of the four profiles of the patients with psoriasis? % 45% % 57% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Very well Somewhat well Average Not very well Not at all No comment

16 Feedback from participants Q3 How likely is it that you can use the contents of the seminar for medical treatment from tomorrow? % 48% % 55% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Very likely Somewhat likely Neither likely nor unlikely Not so likely Not at all likely No comment

17 Feedback from participants 2016 Comment's The humorous role-playing showed how to interact (with the patient) in a convincing way, at it was rather fun. I had not had the opportunity to learn from such an interesting theme thus far. I was able to listen to different opinions of various dermatologists. Thank you for giving me a precious opportunity. I think this seminar can help communicating with the patients considering each of their personalities Comment's I thought that even though without being aware of patient profiling, they were unconsciously divided in actual clinical practice. I thought that keeping it in mind would contribute to establishing better relationships with patients and to avoiding troubles. Videos are done well. The models were close to real patient types. And as compared to the last year, patterns were more understandable due to arranging in a matrix. Because I thought that building rapport within a short time is very important for enhancing patient s adherence.

18 National roll-out experience in China Xibao Zhang, Professor Institute of Dermatology, Guangzhou Medical University

19 Psoriasis Academy in China Past

20 LEO Psoriasis Academy 2015 in China October 31-November 1, 2015, Shanghai, China 10 Chinese dermatologists attending this academy conference in Shanghai

21 The 1st Psoriasis Academy Meeting in China January 15, 2016, Shanghai In this meeting, the materials for Psoriasis Academy Training in China were selected and discussed.

22 The 2nd Psoriasis Academy Meeting in China May 27, 2016; Xia Men, Fujian Province More than 50 dermatologists attending the training couse. This training meeting was part of continuous medical education section of 2016 CMA annual meeting in Xiamen.

NEGATIVE EXPERIENCE POSITIVE EXPERIENCE The four segments all have distinct problems with prescription topicals Self-manager Irregular treatment (mix and match/fire

Actively engaged The burden of treatment is high (time, yuckiness), but due to satisfaction with efficacy, PTs are used compliantly I must improve my condition, so

Dropped out after a frustrating experience of trial-and-error with PTs There are no creams that help, so why bother then?

23 NEGATIVE EXPERIENCE POSITIVE EXPERIENCE The four segments all have distinct problems with prescription topicals Self-manager Irregular treatment (mix and match/fire fighting) caused by a fear of side effects and an unmet need for more specific treatments I know cortisone creams help but I use them only sometimes. Actively engaged The burden of treatment is high (time, yuckiness), but due to satisfaction with efficacy, PTs are used compliantly I must improve my condition, so compliance is essential. Among PTs, there are not enough choices LOW DISEASE IMPACT PTs are still a compromise HIGH DISEASE IMPACT Why me? Dropped out after a frustrating experience of trial-and-error with PTs There are no creams that help, so why bother then? Help me Deep disappointment with efficacy of PTs, therefore not considering them as proper medical treatment Creams are creams, a waste of time I want real medicine. Given up on PTs and the HCS Overall low involvement with medicine HCS, healthcare system; PT, psoriasis treatments

NEGATIVE EXPERIENCE POSITIVE EXPERIENCE We identified different means to increase the segments satisfaction with prescription topical efficacy Self-managers require Focused treatments with short-term

24 NEGATIVE EXPERIENCE POSITIVE EXPERIENCE We identified different means to increase the segments satisfaction with prescription topical efficacy Self-managers require Focused treatments with short-term results Treatments that live up to their fear of side effects (especially their reluctance towards steroids) Products specialised in reducing visibility Actively engaged require Further improved products (regarding efficacy and burden of treatment) A sustainable treatment Informed about new treatments LOW DISEASE IMPACT HIGH DISEASE IMPACT Why me? require Effective and low burden medical treatments A better and less confusing understanding of psoriasis An environment that understands and cares about their psoriasis Help me require Conviction that products have real medical value A systemised treatment regimen Clearer instructions and increased care New hope, quick wins

25 Profile: Actively engaged Actively engaged 16% 40% use prescription medicine and 40% use non-prescription medicine Have the most positive relationship with their HCP Tend to trust their HCP the most Tend to have a good level of satisfaction of topicals The most adherent segment (54%) 56% have moderate psoriasis; 33% mild

26 Actively engaged The burden of treatment is high (time, yuckiness), but due to satisfaction with efficacy, PTs are used compliantly

27 Actively engaged: Presented Case Gender: Male Age:50 years Occupation: Boss of a firm in Guangzhou, China Diagnosis: Plaque psoriasis History: More than 10 years, he is the only one psoriasis case in his family PASI Score:18

28 Actively engaged: Presented Case Attitude: actively engaged to look for any medication and/or therapy to be used in treatment for his disorder; Topical medication, MTX, retinoid, cyclosporine, topical and systemic TCM have been used for many rounds, the outcome is not satisfied, the recurrence was always occurred when he was stop treatment; He still dreamed to find a way by internet, journals, textbooks, Google anyway he can be utilized, to be cured his illness;

29 Actively engaged: Presented Case Current situation: Humira (adalimumab) monotherapy has been used for his treatment, the response is magically good enough, the skin lesions have been totally clearly. PASI score is 0 (18 to 0) after adalimumab treatment for two weeks later. The therapy is still on going.

30 Before treatment After two weeks treatment

31 Before treatment After two weeks treatment

32 Before treatment After two weeks treatment

33 Before treatment After two weeks treatment

34 Worry is still exited in the case Even the response is satisfied; Skin lesions were totally clearly; PASI score from 18 to 0.; The therapy is so simple that only two weeks for one injection; But, The new problem is coming: 1. How long time can be kept in current situation? 2. when the skin lesions will be still coming? So. The worry is always never be stop for patient with psoriasis including medical physician, because until today, in all of our knowledge, Psoriasis is never can be cured.

35 Psoriasis Academy World Summit Professor Xibao Zhang 19 November, 2016; Frankfurt, Germany W ELCOME DINNER W HERE ARE W E GOING? HOW ARE W E DOING? SHARING OUR EXPERIENCE Dinner talk Dr Bewley 18 th November Prof Reic h 19 th November Discussion forum Prof Mroweitz Global fac ulty Discussion forum Prof Lam bert & Prof Zimmo LEARNING INTO PRACTICE W orkshop Interac tive pos ters MEASURES OF SUCCESS Discussion forum Prof Lam bert & Dr Bewley Global fac ulty Dr Hood, Prof Ers s er & Dr Bewley

36 Sharing our experience and Interactive posters 19 November, 2016; Frankfurt, Germany

37 Psoriasis Academy in China

39 SHARING OUR EXPERIENCE

40 Is psoriasis only a skin disease????

41 Dandelion action for psoriasis in China ---Help physicians to helping more psoriasis patients

42 Dandelion action for psoriasis in China Dandelion action for psoriasis in China is similarly to Psoriasis Academy in the globe; We imaged that the seeds of dandelion can go with wind reach to anywhere in China, the knowledge on psoriasis reach to every psoriasis patient in China. Every case can be helped by this action.

43 Dandelion action for psoriasis in China Where are we going? What we can do for psoriasis? How are we doing? How we can release the patient from the disease burden? Sharing our experience. To improve our clinical skill and experience to help our patient with psoriasis. Patient education. What is psoriasis? How to treat the disease? How to get with the disease in your life.

44 Dandelion action for psoriasis in Huashan hospital, Shanghai, China

45 Dandelion action for psoriasis in Huashan hospital,shanghai, China

46 Dandelion action for psoriasis in Guangzhou institute of dermatology, Guangzhou, China

47 Dandelion action for psoriasis in Guangzhou institute of dermatology, Guangzhou, China Patient education section

48 Dandelion action for psoriasis in Beijing Traditional Chinese Medicine hospital, Beijing, China

49 Dandelion action for psoriasis in Beijing Traditional Chinese Medicine hospital, Beijing, China

50 Dandelion action for psoriasis in Beijing Traditional Chinese Medicine hospital, Beijing, China

51 Dandelion action for psoriasis in Beijing Traditional Chinese Medicine hospital, Beijing, China

52 Dandelion action for psoriasis in Beijing Traditional Chinese Medicine hospital, Beijing, China Patient education section

53 Dandelion action for psoriasis in Fujian Medical university, Fuzhou, China

54 Dandelion action for psoriasis in Fujian Medical university, Fuzhou, China Patient education section

55 Dandelion action for psoriasis in Fujian Medical university, Fuzhou, China

56 Dandelion action for psoriasis in Changsha Dermatology Association, Hunan, China

57 Dandelion action for psoriasis in Changsha Dermatology Association, Hunan, China

58 Dandelion action for psoriasis in Hebei Dermatology Association, Shijiazhuang, China

59 Dandelion action for psoriasis in Hebei Dermatology Association, Shijiazhuang, China

60 Dandelion action for psoriasis in Hebei Dermatology Association, Shijiazhuang, China

61 Dandelion action for psoriasis in Hebei Dermatology Association, Shijiazhuang, China Patient education section

62 Dandelion action for psoriasis in Hebei Dermatology Association, Shijiazhuang, China Patient education section

63 Thanks!

64 National Roll-out experience Psoriasis Academy Sameer Zimmo Professor of Dermatology King Abdulaziz University Saudi Arabia

65 Psoriasis Academy Dubai regional Academy

66 Roll-out 8 sessions in Saudi Arabia. 2 session in UAE. (1 session during a conference) 1 session in Kuwait At Hospitals At Hotel

70 At Hospital Participants: Dermatology staff & residents in the hospital Interns Final year medical students Time: one hour. (Doctors break time) Material given: The Psoriasis Academy presentation file Psoriasis Academy web site address

72 At Hotel Participants: Dermatologists working in Jeddah Time: one & half hour at night (after working hours) Material given: The Psoriasis Academy presentation file Psoriasis Academy web site address

73 Psoriasis Academy Web non-promotional web platform provides access to tools and materials forum to discuss challenges or success stories when implementing the learning's at a local level. Lots of information and slide content is available online to ensure that delegates can adapt the content accordingly.

74 Challenges Time: When can doctors have time to attend? Duration of the session (affected the interaction play) but videos helped a lot Material: short or long Venue Hospital: travelling distant, parking, entrance permit Which Hotel: easy accessibility to all participants Speaker: Dermatologist only. No communication expert.

75 During sessions Patients profiles Communications skills Videos

76 Feedback from delegates extremely positive >90% of delegates were satisfied or very satisfied with the meeting as a whole. I have been practicing for 37 years, I consider myself welltrained, but I still learnt something atthe Academy

77 Feedback Excellent. This is not taught in medical school in the past. First time to have a formal discussion on patient s profile (New information) It s better to organize such workshops in the presence of the patients. Eye contact and other new skills are important in communication with my patient.

78 Feedback Need 1 day Workshop instead of 1hr lecture, to share & apply those information. It's not me only, But others also have problems with their patients. Very helpful and useful for both physicians and patients themselves. I will not remember the difference in patient s profiles as you told us.

79 Feedback Difficult to apply such questionnaire for every patient specially in busy practice. How can I make it as a second nature for me in the clinic? Is it four types only, Or you are simplifying it? Can it be easier than this?

80 Challenge Materials are better to be more simplified and to be provided in native language Duration of the Role out lecture. We could not make more than one hour Difficulties to organize the meeting to be suitable for all participants time

81 Success Excellent feed back Patients profiles was translated to Arabic The videos were great Roll-out took place as planned

82 Thank you

83 future Psoriasis Academy is working on the feedback and areas of improvements. To simplify the process and encourage doctors to use the patients profile Develop tools to measure the effect on patients Introduce the Academy in Dermatology conferences worldwide Publish the Academy experience Involvement of patients societies Can we apply it to all/any disease other than Psoriasis

Saudi Arabia Western Region Psoriasis Academy 2016 Abdelrahman Elrouby LEO Pharma Saudi-Arabia Current status Faculty XX workshops delivered XX participants so far Saudi Arabia: the first faculty

Fatani and Abdulrahman Safwat Psoriasis Academy News letter 18 May,2016 Partners King Abdulaziz University Hospital, Jeddah Jeddah Dermatology club King Khaled National Guard Hospital, Jeddah Herra

[Please list workshop locations] Very helpful and useful for both physicians and patients themselves.

including] XXX XXX Please consider including an image of some of your materials here Key Challenges and successes I will not remember the difference in patient s profiles as you told us.

Materials are better to translated be more simplified and to profiles be provided Dr.Sameer Zimmo the four patients into into Arabic. Arabic. Is it four types only, Or you are simplifying it?

84 Saudi Arabia Western Region Psoriasis Academy 2016 Abdelrahman Elrouby LEO Pharma Saudi-Arabia Current status Faculty XX workshops delivered XX participants so far Saudi Arabia: the first faculty meeting of the Western region in January. From left to right: Moustafa Hussein, Prof Magdy Abdulghani, Prof Mohammed Qari, Prof Ali Raddadi, Dr. Abdullah Abualiat, Prof Sameer Zimmo, Dr. Mohammad I. Fatani and Abdulrahman Safwat Psoriasis Academy News letter 18 May,2016 Partners King Abdulaziz University Hospital, Jeddah Jeddah Dermatology club King Khaled National Guard Hospital, Jeddah Herra Hospital Armed Force Hospital Mecca Abha Roll-out plan XX workshops planned [Please provide duration of workshop, eg 1 hr, 1 day] Feedback from participants First time to have a formal discussion on patient s profile(new information) It s better to organize such workshops in the presence of the patients. Eye contact and other new skills are important in communication with my patient. Workshop for one day is better than solid lecture, in sharing and applying those information. It's not me only, But others also have problems with their patients. [Please list workshop locations] Very helpful and useful for both physicians and patients themselves. Content [Please describe your audience, eg dermatologists, nurses] [Please define the specific aims of your national programme and content] [Please provide details of the content you will be including] XXX XXX Please consider including an image of some of your materials here Key Challenges and successes I will not remember the difference in patient s profiles as you told us. Difficult to apply such questionnaire for every patient specially Challenge in busy practice. Challenge How can I make it as a second nature for me in the clinic? Materials are better to translated be more simplified and to profiles be provided Dr.Sameer Zimmo the four patients into into Arabic. Arabic. Is it four types only, Or you are simplifying it? Please consider including an image of some of your materials here Success Can it be easier than this? Acknowledgements Duration of profiles the Rolediscussed, out lecture. We could not make moreof than one Only Patients without workshops..,hand-out hour. profiles and website were given for reference and further patient learning Success Give me key word for each type. Thanks to our Faculty members, all participants and LEO Pharma Contact Information Prof.Sameer zimmo Prof.Ali Alraddadi Sameer_zimmo@yahoo.com RaddadiAA@ngha.med.sa Dr.Mohammad Fatani Dr.Abdullah Abualiat M_Fatani@yahoo.com Sabualiat@gmail.com

impact of poor adherence is much worse The challenge of poor adherence is likely to rise in magnitude with the

85 Poor adherence to treatment of chronic diseases is a worldwide problem In developed countries, adherence among patients suffering chronic diseases averages only 50% In developing countries, it is assumed that the magnitude and impact of poor adherence is much worse The challenge of poor adherence is likely to rise in magnitude with the continued increase in chronic disease prevalence WHO [date accessed August 2015]

86 Psoriasis is more than a skin condition Figure reproduced from Mrowietz et al. Exp Dermatol 2014;23:

Rationale for Psoriasis Academy programme World Health Organization (WHO) recognises adherence in chronic diseases as one of the most important factors contributing to an efficient therapy Poor

87 Rationale for Psoriasis Academy programme World Health Organization (WHO) recognises adherence in chronic diseases as one of the most important factors contributing to an efficient therapy Poor adherence and subsequently suboptimum therapeutic results leads to increased costs Any intervention leading to improved adherence is regarded as beneficial WHO

patient adherence (and thus patient outcomes) without increasing overall time and cost per patient Support improvement of

89 Key objectives of the Academy To enhance adherence and real-life outcomes for people living with psoriasis Support implementation of patient empowerment in daily clinical practice Disseminate tools or interventions that will help improve patient adherence (and thus patient outcomes) without increasing overall time and cost per patient Support improvement of HCP and patient communication Build a platform for a continuous communication loop with participants through interactions and support

It featured: interactive learning sessions, forum to discuss best

90 Psoriasis Academy developed with leading experts across dermatology, psoriasis, person-centred care and communication. It featured: interactive learning sessions, forum to discuss best practice, workshops where key learnings could be applied during exercises and simulated consultations.

Change/Insert Date & Location via >Insert >Header & Footer To view drawing guides

Change/Insert Date & Location via >Insert >Header & Footer To view drawing guides Patient profiling Who is your patient and what do they want to hear? What are your patient s ideas, concerns, expectations (ICE)? How much do they already know about their psoriasis? Is your patient more