For people with psoriasis and rheumatoid arthritis (RA), finding comprehensive treatment that works can be a lifelong battle. Medications are often expensive and hard to access, appointments with specialists can take months to secure, and lifestyle factors that may contribute to the diseases tend to be left out of the clinician-patient conversation entirely.
Ohio-based healthcare company AndHealth believes it doesn’t have to be that way — and is inviting patients with the conditions to help prove it. Through its innovative study, called Project IMPACT, the company aims to demonstrate that addressing underlying causes (like nutrition, stress, or sleep) alongside conventional treatments (like biologic medications) has the potential to stop the progression of or even reverse autoimmune conditions including psoriasis and RA.
"Insurance doesn't reimburse for a lot of time spent talking to patients about how they can participate in their own care and how they can incorporate lifestyle changes, even though the science is there," says Dr. Myles Spar, AndHealth’s National Medical Director who’s certified in both internal and integrative medicine.
But Project IMPACT’s model is different. It’s whole-person specialty care approach views patients in the full context of their lives—including any social, physical, or financial barriers they face to care—and connects them with coordinated, culturally competent primary and specialty care.
More specifically, Project IMPACT patients first meet with a provider virtually for about an hour. Soon after, they receive a personalized care plan developed by experts that may include specialists, a dietitian, a pharmacist, and a health coach. Depending on their health status, goals, and readiness for change, patients may also receive medications, lab testing, meal delivery, supplements, and wearable health tracking devices — all at no cost to them.
Unlike a clinical trial, where subjects are blindly given either an intervention or a placebo, this study is observational, meaning everyone receives the support they want in the way they want it. "We're analyzing the whole availability of those treatment paths, not testing each path," Spar says. "So signing up for the study doesn't mean you’re signing up to do steps A, B, and C—you’re signing up to have A, B, and C as options, and then choose your own path."
For example, those who want to work with a health coach may learn about what lifestyle changes—be it reducing sugar intake or adding in an after-dinner walk each day—can make the biggest difference in their symptoms. Then, they can call on their coach via an app for support in implementing those new habits along the way.
"The number of touchpoints that we have with patients per week is extraordinary because even me, I'm not gonna bug my doctor with a little thing," Spar says. "But if it's a health coach who says, ‘I want you to bug me,’ patients are more likely to say, ’I did my two-minute meditation today’ or ‘I bought running shoes’ or ‘I noticed that I was able to not snack while I was watching the news.’ So they see the coach as a real buddy."
Ultimately, the company is betting that, when patients are equipped with the right tools, team, and knowledge, they can help improve a condition that they’re often made to believe will only get worse.
"When you're diagnosed with a condition that you didn't pick, one that took control away from you throughout your life, and that makes your life more limited, to suddenly be told, ‘But there is something you can do to get some control back,’ that's hugely empowering," Spar says.
That was the case for Phyllis, a 60-year-old in Mansfield, Ohio whose RA had prevented her from doing what she loved, whether it was dropping by relatives’ homes to play cards or visiting a venue to dance two-step. "I lost interest in wanting to socialize with my friends and family because I just hurt most of the time," she says. Outside of church, she says, "I literally stayed in bed all day."
But through Project IMPACT, Phyllis worked with a physician who seemed "to truly care" and a health coach who helped her eat more fruits and vegetables and limit her sugar intake. Within weeks and even days, "I had more energy and less pain," she says. "I felt rejuvenated."
She also felt like she mattered. When Phyllis told her care team she didn’t have enough gas in the car to get to the clinic for lab work, for example, they swooped in to help. "Traditional healthcare, if you can’t make it there, then you reschedule. And if you don’t reschedule, who cares?" she says. "With this team, if you can’t make it, they try to figure out why. Once they figure out why, then they try to figure out how to fix it. And once they figure out how to fix it, they fix it."
Interested in participating? Project IMPACT is currently enrolling adults 21 and older in Ohio and Indiana who are taking specialty medications (or have been advised by a physician to start one) for psoriasis or RA. For more information or to see if you qualify, visit andhealth.com/impact or email impact@andhealth.com.
"The exciting part," Spar says, "is … you're helping to move this field forward, and you're helping to add to the data that this whole-person specialty care approach works."