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Maleki-Yazdi KA, Heen AF, Zhao IX, Guyatt GH, Suzumura EA, Makhdami N, Chen L, Winders T, Wheeler KE, Wang J, Spergel J, Silverberg JI, Ong PY, O'Brien M, Martin SA, Lio PA, Lind ML, LeBovidge J, Kim E, Huynh J, Greenhawt M, Frazier WT, Ellison K, Capozza K, De Benedetto A, Boguniewicz M, Begolka WS, Asiniwasis RN, Schneider LC, Chu DK. Values and Preferences of Patients and Caregivers Regarding Treatment of Atopic Dermatitis (Eczema): A Systematic Review. JAMA Dermatol 2023; 159:320-330. [PMID: 36696136 DOI: 10.1001/jamadermatol.2022.6045] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Importance Patient values and preferences can inform atopic dermatitis (AD) care. Systematic summaries of evidence addressing patient values and preferences have not previously been available. Objective To inform American Academy of Allergy, Asthma & Immunology (AAAAI)/American College of Allergy, Asthma and Immunology (ACAAI) Joint Task Force on Practice Parameters AD guideline development, patient and caregiver values and preferences in the management of AD were systematically synthesized. Evidence Review Paired reviewers independently screened MEDLINE, Embase, PsycINFO, and CINAHL databases from inception until March 20, 2022, for studies of patients with AD or their caregivers, eliciting values and preferences about treatment, rated risk of bias, and extracted data. Thematic and inductive content analysis to qualitatively synthesize the findings was used. Patients, caregivers, and clinical experts provided triangulation. The GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research) informed rating of the quality of evidence. Findings A total of 7780 studies were identified, of which 62 proved eligible (n = 19 442; median age across studies [range], 15 years [3-44]; 59% female participants). High certainty evidence showed that patients and caregivers preferred to start with nonmedical treatments and to step up therapy with increasing AD severity. Moderate certainty evidence showed that adverse effects from treatment were a substantial concern. Low certainty evidence showed that patients and caregivers preferred odorless treatments that are not visible and have a minimal effect on daily life. Patients valued treatments capable of relieving itching and burning skin and preferred to apply topical corticosteroids sparingly. Patients valued a strong patient-clinician relationship. Some studies presented varied perspectives and 18 were at high risk for industry sponsorship bias. Conclusions and Relevance In the first systematic review to address patient values and preferences in management of AD to our knowledge, 6 key themes that may inform optimal clinical care, practice guidelines, and future research have been identified.
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Affiliation(s)
| | - Anja Fog Heen
- Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Irene X Zhao
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Gordon H Guyatt
- Department of Medicine, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada
| | - Erica A Suzumura
- Department of Preventive Medicine, Faculdade de Medicina Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Nima Makhdami
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Lina Chen
- Faculty of Medicine, University of Ottawa, Ontario, Canada
| | | | | | - Julie Wang
- Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Jonathan Spergel
- Division of Allergy and Immunology, Children's Hospital of Philadelphia, Department of Pediatrics-Perelman School of Medicine at University of Pennsylvania, Philadelphia
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Peck Y Ong
- Children's Hospital Los Angeles, University of Southern California, Los Angeles
| | - Monica O'Brien
- Tufts University School of Medicine, Boston, Massachusetts
| | | | - Peter A Lio
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Mary Laura Lind
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe
| | - Jennifer LeBovidge
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Joey Huynh
- Orthopedic Neurological Rehabilitation, Northridge, California
| | | | - Winfred T Frazier
- Department of Family Medicine, UPMC St Margaret, Pittsburgh, Pennsylvania
| | | | | | - Anna De Benedetto
- Department of Dermatology; University of Rochester Medical Center, Rochester, New York
| | - Mark Boguniewicz
- University of Colorado School of Medicine, Aurora.,National Jewish Health, Denver, Colorado
| | | | | | - Lynda C Schneider
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Derek K Chu
- Department of Medicine, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada.,The Research Institute of St Joe's Hamilton, Hamilton, Canada
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Current Utilization of Qualitative Methodologies in Dermatology: A Scoping Review. JID INNOVATIONS 2023; 3:100172. [PMID: 36891031 PMCID: PMC9986021 DOI: 10.1016/j.xjidi.2022.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/27/2022] [Accepted: 10/03/2022] [Indexed: 11/19/2022] Open
Abstract
The focus of this review was to determine how qualitative methods are used in dermatology research and whether published manuscripts meet current standards for qualitative research. A scoping review of manuscripts published in English between January 1, 2016 and September 22, 2021 was conducted. A coding document was developed to collect information on authors, methodology, participants, research theme, and the presence of quality criteria as outlined by the Standards for Reporting Qualitative Research. Manuscripts were included if they described original qualitative research about dermatologic conditions or topics of primary interest to dermatology. An adjacency search yielded 372 manuscripts, and after screening, 134 met the inclusion criteria. Most studies utilized interviews or focus groups, and researchers predominantly selected participants on the basis of disease status, including over 30 common and rare dermatologic conditions. Research themes frequently included patient experience of disease, development of patient-reported outcomes, and descriptions of provider and caregiver experiences. Although most authors explained their analysis and sampling strategy and included empirical data, few referenced qualitative data reporting standards. Missed opportunities for qualitative methods in dermatology include examination of health disparities, exploration of surgical and cosmetic dermatology experiences, and determination of the lived experience of and provider attitudes toward diverse patient populations.
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Ragamin A, Schappin R, Witkam WCAM, Spiering M, Mendels E, Schuttelaar MLA, Pasmans SGMA. Long term effects of digital education among healthcare professionals in paediatric dermatology: Opportunities for improving care. SKIN HEALTH AND DISEASE 2022; 2:e143. [PMID: 36092257 PMCID: PMC9435444 DOI: 10.1002/ski2.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/05/2022]
Abstract
Background Objectives Methods Results Conclusion
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Affiliation(s)
- Aviël Ragamin
- Department Dermatology, Center of Pediatric Dermatology Erasmus MC University Medical Center‐Sophia Children's Hospital Rotterdam The Netherlands
- Department of Dermatology Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands
| | - Renske Schappin
- Department Dermatology, Center of Pediatric Dermatology Erasmus MC University Medical Center‐Sophia Children's Hospital Rotterdam The Netherlands
- Department of Dermatology Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands
| | | | - Magda Spiering
- Department Dermatology, Center of Pediatric Dermatology Erasmus MC University Medical Center‐Sophia Children's Hospital Rotterdam The Netherlands
- Department of Dermatology Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands
| | - Elodie Mendels
- Department Dermatology, Center of Pediatric Dermatology Erasmus MC University Medical Center‐Sophia Children's Hospital Rotterdam The Netherlands
- Department of Dermatology Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands
| | - Marie L. A. Schuttelaar
- Department of Dermatology University Medical Center Groningen, University of Groningen Groningen The Netherlands
| | - Suzanne G. M. A. Pasmans
- Department Dermatology, Center of Pediatric Dermatology Erasmus MC University Medical Center‐Sophia Children's Hospital Rotterdam The Netherlands
- Department of Dermatology Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands
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Teasdale E, Sivyer K, Muller I, Ghio D, Roberts A, Lawton S, Santer M. Children's Views and Experiences of Treatment Adherence and Parent/Child Co-Management in Eczema: A Qualitative Study. CHILDREN-BASEL 2021; 8:children8020158. [PMID: 33672514 PMCID: PMC7923777 DOI: 10.3390/children8020158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/16/2021] [Accepted: 02/16/2021] [Indexed: 11/16/2022]
Abstract
Eczema affects one in five children and can have a substantial impact on quality of life. This qualitative study aimed to explore children's views and experiences of eczema and what may affect treatment adherence from their perspective. We conducted semi-structured, face-to-face interviews with children with eczema aged 6-12 years from March to July 2018. Interviews were transcribed verbatim and analysed using inductive thematic analysis. We found that children do not typically view eczema as a long-term condition, and topical treatments (predominately emollients) were seen to provide effective symptom relief. Uncertainty around co-managing at home was expressed as children typically felt that parental reminders and assistance with applying different types of topical treatments were still needed. For some children, eczema can be difficult to manage at school due to a lack of convenient access and appropriate spaces to apply creams and psychosocial consequences such as attracting unwanted attention from peers and feeling self-conscious. Treatment adherence could be supported by reinforcing that eczema is a long-term episodic condition, providing clear information about regular emollient use, practical advice such as setting reminders to support co-management at home, and working with schools to facilitate topical treatment use when necessary.
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Affiliation(s)
- Emma Teasdale
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK; (I.M.); or (D.G.); (M.S.)
- Correspondence: ; Tel.: +44-2380-591753
| | - Katy Sivyer
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton SO17 1BJ, UK; or
- Department of Psychology, University of Portsmouth, Portsmouth PO1 2UP, UK
| | - Ingrid Muller
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK; (I.M.); or (D.G.); (M.S.)
| | - Daniela Ghio
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK; (I.M.); or (D.G.); (M.S.)
- School of Health and Society, Allerton Building, University of Salford, Manchester M6 6PU, UK
| | - Amanda Roberts
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham NG7 2RD, UK;
| | - Sandra Lawton
- Department of Dermatology, Rotherham NHS Foundation Trust, Rotherham, S60 2UD, UK;
| | - Miriam Santer
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK; (I.M.); or (D.G.); (M.S.)
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Koster ES, Philbert D, Zheng X, Moradi N, de Vries TW, Bouvy ML. Reducing corticosteroid phobia in pharmacy staff and parents of children with atopic dermatitis. Int J Clin Pharm 2021; 43:1237-1244. [PMID: 33582952 PMCID: PMC8460576 DOI: 10.1007/s11096-021-01241-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 01/18/2021] [Indexed: 11/30/2022]
Abstract
Background Besides physicians, pharmacy staff has an important role to inform patients on appropriate medication use. However, they might also experience corticophobia themselves, affecting patient counseling and subsequently patient’s disease management. Objective Implementation of an intervention for pharmacy staff to improve knowledge and stimulate positive perceptions towards TCS use, in order to reduce corticophobia in pharmacy staff and parents of young AD patients. Setting Nine community pharmacies in the Netherlands. Method We developed an intervention consisting of education of pharmacy staff followed by counseling of parents. The intervention was implemented in pharmacies and intervention effectiveness was studied using a pre-post design with an intervention period of 3 months. At baseline and follow-up (3 months), pharmacy staff and parents completed a questionnaire. Main outcome measure Corticophobia, both beliefs and worries, measured with the TOPICOP questionnaire. Higher scores indicate a more negative attitude. Result Baseline and follow-up data were available for 19 pharmacy staff members and 48 parents who attended a counseling session in the pharmacy. In both groups there was as decrease in negative beliefs and worries towards TCS (p < 0.05). Mean total TOPICOP scores decreased from 42 to 35% and from 33 to 25% for parents and pharmacy staff respectively. Conclusion Our results show the prevalence of corticophobia among parents. Education of pharmacy staff and targeted patient counseling seems to be effective in reducing corticophobia.
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Affiliation(s)
- Ellen S Koster
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO Box 80082, 3508 TB, Utrecht, The Netherlands.
| | - Daphne Philbert
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO Box 80082, 3508 TB, Utrecht, The Netherlands
| | - Xiang Zheng
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO Box 80082, 3508 TB, Utrecht, The Netherlands
| | - Nila Moradi
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO Box 80082, 3508 TB, Utrecht, The Netherlands
| | - Tjalling W de Vries
- Department of Pediatrics, Medical Centre Leeuwarden (MCL), Henri Dunantweg 2, 8934 AD, Leeuwarden, The Netherlands
| | - Marcel L Bouvy
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO Box 80082, 3508 TB, Utrecht, The Netherlands
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Teasdale E, Muller I, Sivyer K, Ghio D, Greenwell K, Wilczynska S, Roberts A, Ridd M, Francis N, Yardley L, Thomas K, Santer M. Views and experiences of managing eczema: systematic review and thematic synthesis of qualitative studies*. Br J Dermatol 2020; 184:627-637. [DOI: 10.1111/bjd.19299] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Affiliation(s)
- E. Teasdale
- Department of Primary Care, Population Science and Medical Education Faculty of MedicineUniversity of Southampton SouthamptonUK
| | - I. Muller
- Department of Primary Care, Population Science and Medical Education Faculty of MedicineUniversity of Southampton SouthamptonUK
| | - K. Sivyer
- Centre for Clinical and Community Applications of Health Psychology University of Southampton Southampton UK
| | - D. Ghio
- Department of Primary Care, Population Science and Medical Education Faculty of MedicineUniversity of Southampton SouthamptonUK
| | - K. Greenwell
- Centre for Clinical and Community Applications of Health Psychology University of Southampton Southampton UK
| | - S. Wilczynska
- Department of Primary Care, Population Science and Medical Education Faculty of MedicineUniversity of Southampton SouthamptonUK
| | - A. Roberts
- Patient and Public Contributor Nottingham UK
| | - M.J. Ridd
- Department of Population Health SciencesUniversity of Bristol BristolUK
| | - N. Francis
- Department of Primary Care, Population Science and Medical Education Faculty of MedicineUniversity of Southampton SouthamptonUK
| | - L. Yardley
- Centre for Clinical and Community Applications of Health Psychology University of Southampton Southampton UK
- School of Experimental Psychology University of Bristol Bristol UK
| | - K.S. Thomas
- Centre for Evidence Based Dermatology University of Nottingham Nottingham UK
| | - M. Santer
- Department of Primary Care, Population Science and Medical Education Faculty of MedicineUniversity of Southampton SouthamptonUK
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