Ginette Okoye, MD: Addressing Care Disparities for HS Patients

In an interview with the HCPLive team, Ginette Okoye, MD, spoke about personal experiences she has had in dealing with hidradentitis suppurativa (HS) patients’ struggles with access to care, as well as strategies that may be utilized to address such issues.

This discussion overall dealt with the most important takeaways from Okoye’s presentation given at the 8th annual Symposium on Hidradenitis Suppurativa Advances (SHSA) Conference on October 13 -15 in Phoenix, Arizona.

Okoye serves both as professor and as chair of dermatology for Howard University’s College of Medicine in Washington, DC.

“We actually did a small internal study in my department where we looked at patients who with HS were prescribed a prescribed a biologic for their HS, and we looked at them over 90 days,” Okoye said. “We saw that in 90 days, only 60% of our patients actually received their medication, and so that was a pretty bracing statistic. Because how do we expect them to get better if 4 out of 10 of them never got the medicine? So we again started asking questions of the patients of pharmacies to figure this out.”

To illustrate the findings, Okoye gave 2 examples from this study. The first was an example of language barriers leading to difficulties for patients of minority backgrounds.

“One is a patient who spoke Amharic as her first language,” Okoye explained. “So we prescribe the medication and then the Specialty Pharmacy has to reach out to the patient, and they will not ship a medication on ice, like a biologic, to a patient unless they reach them by phone. So they would call the patient and she would not understand what they're saying. They also wouldn't understand what she's saying, since they didn't have access to an interpreter for her language. So they never shipped it.”

Okoye added that they saw this woman 3 months later, and she had never gotten her medication.

“So the way that we tried to work around this, and we do this for many patients, is we have the pharmacy ship the medication to us and we keep the medication in our refrigerator with the patient's name and other information,” she said. “And then they come in, and we either give them the medication, or we administer the medication for them. So that's one example.”

Later, Okoye went into the second example from the study she cited in her description

“A good example of how we take things for granted in our position is (we identified) a patient who just never seemed to take the medication,” she said. “They received the medication, but didn't use it. And it was, I think, just having a non-judgmental, sitdown conversation with the patient. We found out that he lived in his car. Sometimes he would live in a motel, sometimes the motel would have a fridge, and he would leave the medicine in the fridge. And then if he got kicked out of the motel, because he didn't pay anymore, that medicine was just left behind.”

Okoye noted that this patient would also periodically stay with friends and might accidentally leave his medication behind in their refrigerators.

“But again, for that patient, our solution was that we'll keep the medicine,” she said. “Just come by once a week, we'll give it to you. And he's doing much, much better.”

Then the question arose about whether this practice could be implemented among most clinicians’ offices for patients facing such challenges.

“I think that there are regional and even institutional rules that could be barriers to that in different places, so I think it's something that any given provider should think about, and investigate to make sure that that's okay,” she said. “But I mean, it's something that's worked for us, we have the institutional permission to do that.”

Okoye further explained that in a private practice, a system will be necessary to ensure that the office keeps different patients’ medications well-organized and easy to access when they visit.

To learn more about the discussion with Okoye, view the full interview above.

The quotes used in this description were edited for clarity.