For patients with psoriasis and rheumatoid arthritis (RA), finding a comprehensive treatment that works can be a lifelong battle: medications are often expensive and hard to obtain, specialist consultations can take months, and lifestyle factors that may contribute to the disease tend to be completely left out of doctor-patient conversations.
AndHealth, an Ohio-based healthcare company, believes that doesn't have to be the case, and it's recruiting patients with these symptoms to prove it. Project IMPACTThe company aims to demonstrate that addressing the underlying causes (such as nutrition, stress and sleep) alongside conventional treatments (such as biologics) may halt or even reverse the progression of autoimmune diseases such as psoriasis and rheumatoid arthritis.
“Despite the scientific evidence, a lot of the time spent talking to patients about how they can participate in their own care and what lifestyle changes they can make is not reimbursed by insurance,” says Miles Spar, M.D., national medical director at AndHealth, who is board certified in both internal medicine and integrative medicine.
But Project IMPACT's model is different: Our whole-person specialty care approach looks at patients in all the contexts of their lives — including the social, physical or economic barriers they may face in care — and connects them to coordinated, culturally competent primary and specialty care.
Specifically, Project IMPACT patients first meet virtually with a health care provider for about an hour. They then immediately receive a personalized care plan developed by experts, including specialists, nutritionists, pharmacists and health coaches. Depending on their health status, goals and readiness to change, patients may also receive medications, lab tests, meal delivery, supplements and wearable health tracking devices — all at no cost to them.
Unlike clinical trials, where participants are blindly given an intervention or a placebo, the study is observational, meaning everyone gets the support they want, in the way they want. “We're analysing the availability of treatment pathways as a whole, we're not testing each pathway,” says Spar. “So taking part in the study doesn't mean you agree to do steps A, B and C. You agree to have A, B and C as options and choose your own pathway.”
For example, someone who wants to work with a health coach can learn what lifestyle changes would make the biggest difference to their symptoms, like cutting back on their sugar intake or taking a walk after dinner every day. They can then connect with their coach through the app to get support in implementing their new habits.
“The number of weekly touchpoints we have with patients is surprising, because even I'm not going to bother a doctor with little things,” Spar says. “But when a health coach says, 'Let me bother you,' patients are more likely to say, 'I meditated for two minutes today,' or 'I bought some running shoes,' or 'I've noticed that I don't snack as much while watching the news.' So they see the coach as a true peer.”
Ultimately, the company believes that if patients are equipped with the right tools, team and knowledge, they can help improve conditions that often seem to only get worse.
“When you've been diagnosed with a disease that you didn't choose and that has taken control away from you and limited your life, it's really empowering to suddenly be told, 'But there are things you can do to take back control,'” Spar says.
That includes Phyllis, 60, of Mansfield, Ohio. Her rheumatoid arthritis has prevented her from doing the things she loves, like stopping by relatives to play cards or going to venues to two-step. “I was in pain most of the time, and it made me less willing to socialize with friends and family,” she says. Outside of church, she says, “I was literally in bed all day.”
but, Project IMPACTPhyllis worked with the help of a doctor who seemed “really caring” and a health coach, who helped her eat more fruits and vegetables and limit her sugar intake. Within weeks, maybe days, “I had more energy and less pain,” she says. “I felt rejuvenated.”
She also felt important. For example, when Phyllis told her medical team she didn't have enough gas to get to the clinic for a test, they rushed in and helped. “In traditional medicine, if you can't make it, we'll reschedule. If you don't reschedule, who cares?” she says. “With this team, if you can't make it, we try to figure out why. Once we know why, we figure out how to solve it. And once we know how to solve it, they solve it.”
Interested in participating? Project IMPACT is currently recruiting adults 21 and older in Ohio and Indiana who are taking (or have been recommended by their doctor to start taking) specialty medications for psoriasis or RA. For more information and to view eligibility, please visit: andhealth.com/impact or email impact@andhealth.com.
“What's great is that we're helping to move the field forward and adding to the data that this holistic approach to specialized care works,” Spar says.
