Assessing Your Treatment Options

You’ll find that there is often more than one treatment option available to you and different types available too (e.g., clinical options like prescription medication; over-the-counter options like creams; nutritional options like diet changes; emotional or psychological options like support groups or therapy; and traditional or complementary options like indigenous traditional healing, traditional chinese medicine, or naturopathy.)

What options are suitable for you may depend on things like the severity of your symptoms and how they are affecting your day-to-day life.

Often it’s safe to combine different treatment options to try to get a better result and achieve your goals. However, it’s very important to be careful about potential known or unknown contraindications. A contraindication is when one treatment interacts negatively with another one and creates harmful effects.

Keep a log in your journal of your current treatment plan. Include everything – whether it’s vitamins you buy or prescription medication. Share your treatment plan with every health provider you see about your psoriatic condition, including your pharmacist. Make sure they’re considering what you’re already taking and doing before they make any new recommendations or change your treatment. Keep notes of any changes in how you feel once a new treatment is introduced alone or in combination with another. Talk to your care team immediately if you notice any harmful effects or have any concerns.

Click on a topic below for more details.

Benefits versus risks

Overview

All treatments, for any health condition, have potential positive effects and potential risks. Many also have uncertainties; things we just don’t know yet. Uncertainties in medicine refer to anything that suggests some level of doubt, or lack of confidence, about a treatment’s positive and negative effects. It can also refer to doubt about when it’s best to use the treatment; who will benefit; or results of studies done to assess the treatment. Every time we make a treatment decision with our care team, we are weighing the benefits, risks, and uncertainties for ourselves.

To start, let’s distinguish between the positive effects, troublesome effects, and negative toxic effects of treatments. It’s important to gather information about potential positive and negative effects of treatments from credible sources, such as your physician(s) and your pharmacist.

Positive Effects

A positive effect of treatment is also called a benefit.

Three kinds of positive effects exist:

  1. A positive effect of treatment can modify disease by slowing it down or even reversing it. This kind of treatment effect may also provide relief from symptoms of the disease.
  2. A positive effect of treatment can manage disease. The treatment does not change the fact that the disease exists. It may prevent the progression or worsening of the disease.
  3. A positive effect of treatment can manage symptoms. The treatment does not change the fact that the disease exists. Instead, its goal is to reduce or control symptoms of the disease, such as itchiness or pain.

To learn more about any specific treatments you are considering for your psoriatic condition, visit this section on Treatments for Psoriasis and Psoriatic Arthritis.

Troublesome Effects

A toxic effect of treatment is also called a harm. A troublesome effect is less serious than a negative toxic effect because it is not life-threatening. Even so, a troublesome effect can be severe, such as a bad headache. A troublesome effect may last only a short time, or it may be present for as long as the treatment continues. It can affect whether you decide to continue a treatment. The same treatment may cause certain troublesome effects in one person, but not in another.

To learn more about any specific treatments you are considering for your psoriatic condition, visit this section on Treatments for Psoriasis and Psoriatic Arthritis.

Negative Toxic Effects

A negative toxic effect is both negative and serious. In rare cases, a toxic effect can cause a severe reaction, like birth defects, drug dependence, or death. Patients must report any noticeable toxic effects to their physician right away, so that the effects do not progress. The same treatment may cause toxic effects in one person, but not in another.

To learn more about any specific treatments you are considering for your psoriatic condition, visit this section on Treatments for Psoriasis and Psoriatic Arthritis.

Research Questions
  • What is known about the positive and negative effects of  this treatment?
  • If the treatment is licensed by Health Canada, how recent was the licensing? For information on licensing visit Health Canada.
    • Was the treatment turned down for licensing or removed from markets anywhere in the world? If so, why?
    • If a treatment is on the market in Canada, is it licensed with full authorization (Notice of Compliance,  or NOC) or with conditional authorization (Notice of Compliance with Conditions, or NOC/C)?
  • Is funding for this treatment covered by any source, such as a provincial, territorial or federal government, the company that manufactures it, or a private insurance company? If not, why? What are my options for coverage?
  • Is there someone within my care team whose job it is to help me figure out how to get my treatment paid for? If not, can anyone in my care team or within a patient group like the Canadian Psoriasis Network connect me to such a person, if they exist in my health system?
  • Are there treatments being researched for my psoriatic condition? What are they? Check out: Clinical Trials.
Toolkit

Here is a tool with questions to help you work with your physician to understand the risks, benefits, and uncertainties of the treatment(s) they’re recommending to you.

Assess the Possible Positive Effects/Benefits
What are the known possible benefits of this treatment for my psoriatic condition? Does it change the way the disease progresses, or does it provide relief from symptoms?
How long does it take before I should feel the benefits of the treatment?
How long does treatment benefit last if I take it as recommended?
Does my doctor believe the studies for this treatment were designed well? Are there new studies on the treatment that deal with the treatment’s benefits once it was used in the general population for some time? If so, what are the results?
Did the research show whether or not this treatment is likely to work for “people like me”? (“People like me” are patients who were part of the study that had the same characteristics as yours, such as your sex, your condition type, the severity of your condition.) If so, how likely is the treatment to work for me?
Did the research show the lowest dose that is effective for a patient like me?
What kind of treatment is it and how is it administered (e.g., pill, cream, injection)?
Is this treatment likely to work on aspects of my psoriatic condition that are most important to me in achieving my goal(s)?

 

Assess the Possible Negative Effects/Risks
How safe is this treatment option for me? What is the likelihood of someone like me experiencing  any harmful or toxic effects?
If I might experience a harmful or toxic effect, can it be managed in my case? How long would it take for me to experience the harmful or toxic effect? If I stop treatment, will the harmful or toxic effect stop? How long after I stop the treatment?
How safe is this treatment option, generally, for most people?
What do I do if I experience a harmful or toxic effect? Who do I contact between appointments if I notice any harmful or toxic effects from the treatment?

 

Assess the Uncertainties
Are there any uncertainties about the treatment that I should consider?
Ask any other questions about what you or your loved one still do not know or feel unclear about when considering the effects of a treatment.
Timing

You want to have a sense of the time period for how long a treatment will take to start working. It’s also important to know who to talk to and what to do next if things aren’t working out as hoped by the end of that time period or if you experience any negative effects from the treatment.

Create a calendar for yourself that tracks your timelines so you remember to follow-up. If you like digital, put it in your phone’s calendar. If you like paper, get a calendar dedicated to tracking the achievement of your goals. Put the timelines in it and put it in your binder. Keep all of the names and contact info for your care team members with your calendar in your binder (or in your phone’s contact list).

Considering Other Impacts of Treatment Decisions

It’s important to realize that some treatment choices may have other impacts on you or your loved one’s lives.

Click for Examples
  • Visits to an office, clinic or hospital and the impact this has on you and/or a loved one’s daily routines
  • Need to travel away from home
  • Need for home care
  • Need to inject yourself on a regular basis
  • Impacts on other treatments being used (e.g., having to stop another treatment or reduce it)
  • Need for other treatments to manage the negative effects of this treatment (new medicines or starting other therapies such as physiotherapy)
  • The commitments required in joining a clinical trial
  • Effects on finances
  • Effects on daily activities or life choices (e.g., making changes to meal times, what foods you eat, or birth control due to the treatment)

Last updated October 28, 2019.

Disclaimer

This Site was designed for educational purposes only and not for the purpose of rendering medical advice. Individual variances in psoriasis cases require the consultation of a physician to make sound medical decisions. The information presented on this website is not intended to replace the counsel of your physician. It is important to see your doctor before altering anything in your treatment plan. The Canadian Psoriasis Network does not endorse any medications, products, equipment or treatments for psoriasis and psoriatic arthritis. Any of the information contained within the Canadian Psoriasis Network’s Site is not presented as a substitute for informed medical advice. Visitors to this site should not engage in self-diagnosis nor act on information contained in the Site without seeking specific advice on the particular matters which are of concern to them from qualified health professionals and advisors. Some of the information contained in the Site has been provided from external sources. While efforts have been made to ensure the accuracy, currency, and reliability of the content, the Canadian Psoriasis Network accepts no responsibility in that regard. Please refer to our Terms of Use for further details.

This resource was made possible through support from:
Abbvie
Pfizer
Janssen
Bausch
 
LEO Pharma
Novartis
Amgen

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