Patient Care and Monitoring

With respect to pharmacologic therapies, it is important to:

• Provide patients with an approximate time frame for improvement based on the patient's areas of involvement and type of drug therapy. For example, a statement such as: "There should be less scaling and redness of your scalp lesions and a reduction in the thickly crusted areas within 1 to 2 weeks. You should notice a general improvement in your condition by 6 to 12 weeks. Your palms, soles, elbows, and knees may take longer to clear."9

• Provide appropriate advice about drug regimens including how to apply a specific topical agent, how to use a specific systemic agent, and precautions and possible toxicities of any drug therapy, remembering that topical therapies can have significant systemic adverse effects.

• Check the patient profile and talk with the patient to ensure that there are no significant drug interactions with other concurrent medications and therapies.

• Reinforce the importance of adherence to therapies and specific drug regimens.

• Reinforce the importance of regular follow-up with the patient's health care providers including all appointments for follow-up care and lab work (if any).

• Interact with the patient's other health care providers as needed to discuss patient concerns or issues detected including drug interactions, nonadherence, and adverse effects.

• Topical corticosteroids: Monitor for skin thinning, telangiectasias, and possible hy-pothalamic-pituitary-adrenal axis suppression.

• Interact with the patient's other health care providers as needed to discuss patient concerns or issues.

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