The IMPACT Programme in Psoriasis: Phase I - where we are now and future directions

Psoriasis is a common, life-long inflammatory skin condition associated with high levels of physical, psychological and social disability as well as co-morbidities including psoriatic arthritis, the metabolic syndrome, Crohn's disease and non-alcoholic fatty liver disease. Psoriasis is also associated with an increased risk of cardiovascular disease (CVD), however the relationship is not yet wholly understood and is confounded by common co-occurrence of unhealthy lifestyle behaviours such as smoking, drinking excess alcohol or being overweight or sedentary. CVD risk information is complex for clinicians to communicate and patients to understand, and supporting risk-reducing strategies in the form of lifestyle behaviour change is challenging, particularly when people are already living with a demanding long-term condition. Additionally, there are indications that patients are dissatisfied with psoriasis care and that treatment approaches may be inadequate. IMPACT is a five-year programme of applied research, funded by NIHR, which aims to improve health services for people with psoriasis. It comprises a multi-disciplinary team of academics, clinicians and patients and draws on a range of research approaches. Phase I of the programme involves four interlocking workstreams, each focused on key questions in psoriasis management. All findings from Phase I have informed the planning and development of a final workstream (Phase II), the Psoriasis and Wellbeing ('Pso Well'®) intervention, comprising a practitioner training package and new patient resources to support people living with psoriasis to self-manage in the best ways. This article summarises the key findings of IMPACT Phase I and describes the Phase II next steps.