Novartis

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Speak the Same Language in PsA

Speak the Same Language in PsA

Help improve the dialogue between psoriatic arthritis patients and their rheumatologists to enable effective disease diagnosis and treatment
stage:
Enter
prize:
$32,000
Overview

Challenge Overview

Problem Statement

The healthcare community is looking for new ways to improve diagnosis and treatment of Psoriatic Arthritis (PsA), an inflammatory auto-immune disease (the result of an overactive immune system). Subjective symptoms such as joint pain, stiffness, and tenderness can often lead to frustration and missed opportunities for better care. In fact, one study found that mis-alignment between patients and physicians on treatment satisfaction is associated with increased disease activity and worse impact on quality of life.[1] It’s important for patients with PsA to treat their condition early, because if left untreated, it can lead to permanent and irreversible joint damage.

This challenge is looking for a simple and easy to adopt solution to help:

  1. Patients communicate the full history of their symptoms and impact on their quality of life during doctor visits in the most relevant way;
  2. Physicians measure the severity and progression of their patients’ psoriatic arthritis symptoms and the impact on their quality of life; and
  3. Prompt a conversation between physicians and patients about how to take appropriate steps to improve disease outcomes

The solution should easily enable the physician to better understand the patient’s end-to-end experience, regardless of how much the patient recalls or measures their daily impact and how much time the physician has with them to evaluate the patient’s status. 

Ultimately, the solution will improve measurement of irregular and variable physical and emotional symptoms so both PsA patients and healthcare providers can evaluate the degree of severity and impact on quality of life. This more accurate understanding of patients’ symptoms will ease the development of treatment plans that match the severity and bothersomeness of patients’ symptoms.


References:

[1] Furst DE et al. Misalignment between physicians and patient satisfaction with psoriatic arthritis disease control. Clin Rheumatol. 2017;36(9):2045-2054.

Guidelines

Challenge Guidelines

Current Context: 

Psoriatic arthritis (PsA) is estimated to affect up to 50 million people worldwide[1],[2]. It is a complex disease with multiple symptoms that may appear in patients[3]. Symptoms of PsA include joint pain and stiffness, skin and nail psoriasis, swollen toes and fingers (dactylitis), persistent pain and/or swelling where the tendons attach to bones (enthesitis), and irreversible joint damage[4]. If left untreated, inflammation in PsA can lead to permanent joint damage (bone erosion and new bone formation), leading to severe physical limitations and disability. 

As of today, the existing resources developed for PsA patients to communicate the severity and frequency of their symptoms to practitioners have not been adequate. Limitations include:

  • Specificity to PsA: Many of these measures have been based on Rheumatoid Arthritis, rather than the specific symptoms of Psoriatic Arthritis, which could delay appropriate treatment.
  • Ease of use: While there are several symptom assessment methodologies used in clinical trials (e.g. ACR 20, PASI, LDI, DAPSA, PASDAS), they are not commonly used in everyday healthcare provider practices with patients. This is due, in part, to time constraints during office visits and because patients face challenges in doing manual daily tracking. Ideally, patients could track their symptoms via latent tracking, with data then directly fed into their healthcare provider’s electronic medical records.
  • Time bias: When asked by a healthcare provider about their symptoms, patients who do not track symptoms on a daily basis may emphasize the symptom they are experiencing “now”. They may not remember, or be able to effectively portray, the full picture of how the disease waxes and wanes, where symptom flares and remissions occur over a longer time period. For example, the RAPID3 survey is one measurement more commonly conducted in office visits, but it only reflects symptoms experienced over the past week.[5] Because of this, both patients and practitioners may underestimate the frequency and severity of symptoms, causing patients not to be optimally treated.
  • Objectivity: Research indicates that healthcare practitioners may underestimate the frequency, severity, and bothersomeness of symptoms reported by patients. Whether it is caused by practitioners not collecting this information from the patients or by patients failing to provide it, the end results are patients who are treated less than optimally.[6]

 

Desired Solutions:

This challenge is looking for a simple and easy to adopt solution to help:

1. Patients communicate the full history of their symptoms and impact on their quality of life during doctor visits in the most relevant way

The solution should help patients better speak to specifics about what they can and cannot do since their last visit, not just the particular week or day when they are asked.  When doctors ask their patient a broad question like "How are you feeling?" they don't get enough information to truly assess the patient’s condition. 

A successful solution will address the situation in which patient symptoms flare and resolve prior to the doctor appointment, and also allow tracking of changes in severity or frequency.

The solution should also be easy to use by the patient, without requiring daily log-ins or burdensome tracking of symptoms. It could be something like a tool that monitors symptoms over time, in a more latent way, so patients aren’t reminded daily that they are sick.

2. Physicians measure the severity and progression of their patients’ psoriatic arthritis symptoms and the impact on their quality of life. 

The solution should target the moment of conversation between patient and physician to convey information about the patient’s journey over time in order to better understand the disease progression and match it with an appropriate treatment. 

It should objectively convey clinical measures (pain, redness, swelling, inflammation, mobility, etc.) and social/emotional measures (quality of life, mood, limitations on daily activities, etc.).

The solution should provide output that a rheumatologist can understand quickly and effectively. The solution might not depend on changes in patients or physicians habits/behaviors but adapt to the dynamics that are present today in the physician-patient interaction during visits. Physicians prefer that the output is automatically uploaded into their existing EHR / EMR system, so they don’t have to manually enter the information into the patient chart.

3. Prompt a conversation between physicians and patients about how to take appropriate steps to improve disease outcomes

Ultimately, by improving measurement and communication of psoriatic arthritis symptoms, the solution should help create a more meaningful conversation around quality of life issues between the patient and their healthcare provider. Where the patient is not seeing optimal outcomes, the solution should prompt a discussion about potential treatment adjustments, where medically appropriate.

Examples of potential solutions include algorithms, mobile or website applications, social media campaigns, behavioral change for physicians, patient awareness drivers, physician education platform on severity of disease, physician toolkit, communication or conversation guides, and more. The solution does not have to be a digital solution, and Novartis is welcoming a wide range of blue sky ideas to address this problem statement.

 

Challenge Parameters

Intellectual Property (IP)Winning solutions will be subject to a royalty-free, shared license with Novartis. Please refer to the Challenge-Specific Agreement for details of our IP arrangement. When you submit your proposal, you’ll be asked to confirm that (1) you have full rights over your own IP and (2) if you are selected as a finalist, you will agree to a royalty-free shared license with Novartis.

Participant EligibilityIn addition to confirming the Intellectual Property criteria, all participants who submit solutions to this challenge must confirm that they:

  • Are 18 years of age or older
  • Not employed by a foreign (ex-US) government or foreign (ex-US) publicly-funded entity

 

Evaluation Framework

The solution is rated based on a weighted average of the following criteria. 

Impact (30)

  • Does the proposed solution help create more meaningful conversation around psoriatic arthritis symptoms and quality of life issues between patients and healthcare providers?

Originality (30)

  • Is the proposed solution an improvement over existing methods?

Suitability (25)

  • To what extent does the proposal specifically address the design requirements described in the challenge?

Implementation (15)

  • Is there a viable path to implement the proposed solution?

 

Challenge Prize

Winner: $25,000

Second place: $5,000

Third place: $2,000

In addition, the creators of top rated solutions may be invited to pitch their idea to Novartis Rheumatology leadership.

 

References:

[1] National Psoriasis Foundation. Statistics. Available at: https://www.psoriasis.org/content/statistics. Last accessed: October 2019.

[2]Mease PJ et al. Managing patients with psoriatic disease: the diagnosis and pharmacologic treatment of psoriatic arthritis in patients with psoriasis. Drugs 2014;74:423-41

[3] Kavanaugh A et al. Psoriatic Arthritis and Burden of Disease: Patient Perspectives from the Population-Based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) Survey. Rheumotol Ther. 2016; 3(1); 91-102.

[4] Kavanaugh A et al. Psoriatic Arthritis and Burden of Disease: Patient Perspectives from the Population-Based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) Survey. Rheumotol Ther. 2016; 3(1); 91-102.

[5] See example form: https://www.rheumatology.org/Portals/0/Files/RAPID3%20Form.pdf

[6] As an example from another disease area (oncology), one study found that symptoms including pain were underestimated by healthcare providers for approximately 10% of patients leading to less than optimal treatment regimens. Laugsand, E. A., Sprangers, M. A., Bjordal, K., Skorpen, F., Kaasa, S., & Klepstad, P. (2010). Health care providers underestimate symptom intensities of cancer patients: a multicenter European study. Health and quality of life outcomes, 8, 104. doi:10.1186/1477-7525-8-104, available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2949821/

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