{"version":"1.0","type":"rich","provider_name":"Acast","provider_url":"https://acast.com","height":250,"width":700,"html":"<iframe src=\"https://embed.acast.com/$/6490a6a7bf64170011e867ff/681339886ac0e5213bcf34f0?\" frameBorder=\"0\" width=\"700\" height=\"250\"></iframe>","title":"Defining Difficult-to-Treat and Complex-to-Manage Psoriatic Arthritis","description":"<p>In this compelling episode of <em>Inside GRAPPA</em>, host Dr. Hanna Johnsson, a rheumatologist based in Scotland, leads an important conversation on one of the most pressing issues in psoriatic arthritis (PsA) care: what truly makes a case <em>difficult to treat</em> or <em>complex to manage</em>?</p><p><br></p><p>Dr. Johnsson is joined by two experts deeply embedded in the GRAPPA initiative to define these concepts:</p><ul><li>Dr. Fabian Proft, Head of the Division of Rheumatology at Charité Berlin, Germany, and long-time GRAPPA contributor.</li><li>Dr. Shikha Singla, Assistant Professor of Medicine at the Medical College of Wisconsin, who brings firsthand experience from her combined rheum-derm clinic.</li></ul><p><br></p><p>Together, they unpack the background, progress, and patient-centered approach of the<a href=\"https://www.grappanetwork.org/d2t-psa/\" rel=\"noopener noreferrer\" target=\"_blank\"> Difficult-to-Treat (D2T) and Complex-to-Manage PsA Project</a>.</p><p><br></p><h3><strong>✅ Highlights</strong></h3><ul><li>Clearer definitions aim to improve care for patients with persistent symptoms despite treatment</li><li>“Difficult to treat” focuses on ongoing inflammation; “complex to manage” accounts for non-inflammatory factors</li><li>A global literature review revealed inconsistent criteria in defining treatment challenges</li><li>Surveys of clinicians and patients shaped a more inclusive, consensus-driven framework</li><li>New definitions to be presented at EULAR—marking a major milestone in PsA research</li></ul><p><br></p><h4><strong>⏱ Timestamps</strong></h4><ul><li><strong>00:00</strong> – Introduction to the episode and today’s topic</li><li><strong>00:36</strong> – Guest introductions: Dr. Fabian Proft and Dr. Shikha Singla</li><li><strong>01:00</strong> – Fabian on the need for better definitions and understanding treatment failure</li><li><strong>04:12</strong> – Defining the terms: inflammation vs. non-inflammatory drivers of disease burden</li><li><strong>05:15</strong> – Why “complex to manage” is more appropriate than “difficult patient”</li><li><strong>06:00</strong> – How terminology shapes perceptions and supports more empathetic care</li><li><strong>06:42</strong> – Scoping literature review: methods and inconsistencies in existing definitions</li><li><strong>07:57</strong> – Healthcare provider survey: over 200 responses, strong support for two definitions</li><li><strong>09:12</strong> – Patient survey: nearly 600 responses and insights into global experiences</li><li><strong>10:21</strong> – Patient-reported challenges: joint pain, fatigue, medication side effects</li><li><strong>11:54</strong> – Cultural and social factors influencing patient experience</li><li><strong>12:39</strong> – The Delphi process and achieving expert consensus</li><li><strong>13:15</strong> – Project milestones: EULAR submission and upcoming publications</li></ul><p><br></p><h3><strong>📚 Resources</strong></h3><ul><li>Explore the full scope of this initiative on the<a href=\"https://www.grappanetwork.org/d2t-psa/\" rel=\"noopener noreferrer\" target=\"_blank\"> GRAPPA D2T PsA Project Page</a>.</li></ul><p><br></p><h3><strong>🔗 Links and Social Media</strong></h3><ul><li>Visit our<a href=\"http://grappanetwork.org/\" rel=\"noopener noreferrer\" target=\"_blank\"> Website</a> for more information.</li></ul><p><br></p><p>Follow us on<a href=\"https://www.youtube.com/@grappa5206\" rel=\"noopener noreferrer\" target=\"_blank\"> YouTube</a>,<a href=\"https://www.facebook.com/GRAPPAnetwork\" rel=\"noopener noreferrer\" target=\"_blank\"> Facebook</a>, and<a href=\"https://twitter.com/grappao\" rel=\"noopener noreferrer\" target=\"_blank\"> Twitter</a>.</p>","author_name":"GRAPPA Network"}