NPs, PAs learn evidence-based medicine, practical pearls

More than 250 nurse practitioners (NPs), physician assistants (PAs) and dermatologists from around the U.S. gathered at the DERM (DEF Essential Resource Meeting) 2016 annual meeting last week in Las Vegas.

The Dermatology Education Foundation hosts an annual conference that aims to provide a high level of continuing medical education (CME) case-based content for NPs and PAs, delivered by world-renowned thought leadership, according to Joseph Gorelick, MSN, FNP-C, founder and president of the Dermatology Education Foundation and DERM2016 chairman.

Joe Gorelick, MSN, FNP-C“We literally had world leaders in multiple disease states, such as psoriasis, acne, atopic dermatitis and dermoscopy, on our faculty again this year,” Gorelick says. 

Providing NPs and PAs who work in dermatology with a high level of CME is important, Gorelick says, because these providers do not have fellowships or clinical rotations like those available to physicians.

The DERM2016 CME Conference offered American Academy of Physician Assistants (AAPA) self-assessment course credit, as well as American Medical Association Physician’s Recognition Award 1 (AMA PRA 1) continuing medical education credit. The DEF website, www.dermnppa.org, will offer additional CME credit and informative content throughout the year in between live meetings. The DEF advisory council of NPs and PAs helps form and review the meeting content. And this last conference hosted more than 50 dermatology companies, which interacted with the attendees, according to Gorelick.

“It’s necessary that we get advanced up-to date training through exposure to programs like this … so that we may be updated on current treatment protocols, disease pathophysiology and new therapeutic agents, so that we can provide the best care possible for our patients,” Gorelick says.

Some of the pearls offered by meeting faculty, include:

Diane M. Thiboutot, M.D., offers tips for NPs and PAs when using isotretinoin. Dr. Thiboutot says that it’s important to start patients at the right dose of isotretinoin to avoid risk of flares. For patients with highly inflammatory acne, this involves use of prednisone and starting with a lower dosages of isotretinoin. Another pearl: Research suggests that the associations of isotretinoin with inflammatory bowel disease, depression or suicide have not held up in the more recent epidemiologic studies. 

Hilary E. Baldwin, M.D., addresses new studies looking at laboratory results from patients treated with oral medications for acne, including isotretinoin and spironolactone. The first study looked at laboratory monitoring for acne patients on isotretinoin, which suggests that providers might not need to look monthly at lab tests for those patients. As long as at eight weeks blood tests looked normal, there was no evidence that at 20 weeks things were going to be different. The second study on spironolactone looked at potassium levels in young, healthy people taking 100 mg or less of spironolactone. The basic finding is that laboratory monitoring of potassium in healthy young patients taking spironolactone is unnecessary.

Theodore Rosen, M.D., tackles two aspects of atopic dermatitis that he says don’t get enough attention. One is the mental burden of atopic dermatitis. A recent study suggests more than 30 percent of people with atopic dermatitis have clinical depression, including suicidal ideation. Providers should be aware of this and consider these patients may need the intervention of a mental health professional. The other issue, particularly in children with sleep abnormalities and adults with insomnia, is development of attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD), making it difficult for these patients to focus on tasks. This is because the itch from their atopic dermatitis is disturbing their sleep. Providers should ask patients about difficulties in focusing, concentrating and completing tasks, and might consider referral to a sleep specialist.

DERM2017 will be returning to the Wynn in Las Vegas, July 20 through 23rd. DERM 2017 registration is open at www.dermnppa.org.