The Boxed Warning Toolkit: What Do Derms Need to Know was a brand-new session at the 2023 South Beach Symposium (SBS). Led by SBS Planning Committee Member, Christopher G. Bunick, MD, PhD, this eye-opening session also featured talks from experts, Leon H. Kircik, MD, William E. Damsky, MD, PhD, and Andrew F. Alexis, MD, MPH.
Myths vs. Science
Dr. Bunick began the session with an interesting talk on Myths vs. Science. Here, he addressed nine myths surrounding boxed warnings, providing attendees with evidence to dispel these common misconceptions. Among these is the myth that boxed warnings do not appear on over-the-counter medications. Dr. Bunick pointed out that the commonly used Motrin in fact has a boxed warning.
When Not To Prescribe
The topic of when not to prescribe certain medications was led by Dr. Kircik. He reviewed some of the wording on many package inserts seen in common medications, stating that if physicians were to not prescribe based on the wording and warnings alone, they would never prescribe anything. According to Dr. Kircik, “It’s up to us as providers to judge a package insert and use it accordingly as we understand.”
What Happens When...
Dr. Damsky then took to the stage to discuss ‘What Happens When…’. Making specific reference to Janus kinase (JAK) inhibitors, Dr. Damsky revealed how he discusses safety issues and risks with his patients.
He mentions that patients do not necessarily know what to do with the list of risks on boxed warnings and therefore are looking to you as their provider to guide them. It can be helpful to demonstrate the reasons why they are a good candidate for the medication you are suggesting.
How To Address Patient Concerns
Addressing patient concerns is an essential aspect of any consultation and treatment program. Dr. Alexis provided attendees with the necessary tools required to help patients understand where the boxed warnings originate from and how to alleviate their fears. He explained that if a patient does not belong to a particularly high-risk group, it can be beneficial to point this out, explaining why they would be a good candidate for the medication being recommended.
Dr. Alexis also mentioned that patients need to be assured they will still be monitored closely for any side effects. He reiterated Dr. Damsky’s point of shared decision-making. “Presenting all the information in an individualized and nuanced manner that takes into account the context of that specific patient, the patient can make an informed decision and you can move forward and have a happy patient and an ongoing good relationship with that patient”.
The session ended with a question-and-answer session where participants had the opportunity to seek the experts’ opinions on prescribing certain medications.