Anna B Fishbein, Karen Kaiser, Sarah B Welch, Catherina Lu, Jack Osborn, Jessica Thomas, Michelle Taddeo, Hosanna An, Andie Kwon, George Luong, Kenneth L Zhang, Stephanie M Rangel, Amy S Paller, James W Griffith
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引用次数: 0
Abstract
Background: Atopic dermatitis is a common chronic skin disease that involves frequent physician visits and often complex care plans. Despite the expanding therapeutic options, there is no existing decision aid to guide patients, families, and clinicians through treatment options.
Objective: Our objective was to develop an evidence-based decision aid that would be widely accepted for shared decision-making in pediatric atopic dermatitis.
Methods: Per rigorous International Patient Decision Aid Standards, the following steps were taken: (1) literature review; (2) focus groups with patients and caregivers; (3) expert interviews; (4) prototype creation, revision, and pilot testing in the clinic; and (5) further in-clinic testing.
Results: Six focus groups provided insight into patient/parent preferences (n = 32) regarding treatment experiences and preferences. Nine expert interviews revealed implementation strategies for shared decision-making, eliciting themes of communication, patient education, challenges to and supports for treatment adherence, useful materials/resources, and other strategies for success. Using content from literature review, patient/parent focus groups, and expert interviews, a draft decision aid was systematically created. Cognitive interviews (n = 10) with patients/parents resulted in tool refinement. In-clinic testing demonstrated that the tool was helpful; an average ± standard deviation score was 7.8 ± 1.7 (0-10 scale, n = 18). A final decision aid was produced.
Conclusions: A decision aid for children with atopic dermatitis can be used for clinical encounters and has the potential to improve patient/family engagement in decision-making. In addition, we include a worksheet on patient/parent values and an eczema action plan for implementation. Efficacy of this tool will be tested across populations in future studies.
期刊介绍：
JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases.
This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders.
The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.
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