3 Reasons to Use the EczemaWise App Today
Do you ever feel like your eczema is a moving target? EczemaWise, the app created by the National Eczema Association, is here to help.
Published On: Mar 21, 2023
Last Updated On: Mar 21, 2023
The NEA research team has published its latest paper on shared decision making (SDM), or the process through which patients and/or caregivers and healthcare providers (HCPs) work together to make informed decisions about treatments and/or care plans.
This new research, published in the Journal of the American Academy of Dermatology International (JAADi), is the second publication from the survey NEA conducted in early 2021 of its patient and caregiver community regarding their experiences, preferences and motivators for SDM. The first publication was ranked #3 in JAMADerms’s Most Talked About Articles of 2022
The survey provided a number of factors related to SDM, asking respondents (840) to rate each on a scale from 0 (not important at all) to 4 (absolutely essential), as well as how often these factors were true with their current eczema HCP.1 Factors included aspects about the HCP, the patient, the visit and the guidance provided.
Respondents were considered to have their “needs met” if they indicated a factor was very important or absolutely essential and also reported it as usually or always true. For the nine factors deemed very important/absolutely essential by at least 80% of respondents, the percentage of respondents who indicated their needs were not met ranged from 11.4%–36.3%.1
Overall, this paper revealed that eczema patients and caregivers want to be involved in decision making for their treatments and that SDM is more likely to be facilitated when patient education and empowerment are combined with HCPs who initiate treatment discussions and are compassionate listeners to patient perspectives.
Eczema patients and caregivers overwhelmingly prioritized HCPs who elicit trust, listen to their perspectives and value their input in order to feel comfortable engaging in SDM. Trust in an HCP has been shown to increase treatment adherence, while strong patient-HCP relationships can decrease potentially costly communication errors (in more ways than one).2–7 A recent study of over 38,000 reviews of general dermatology clinics concluded that a HCP’s personality, empathy and kindness may help overcome other issues that are out of their control.8
Although the current study showed that few eczema patients perceived that the race, ethnicity and gender of their HCP matching their own was important for SDM, as many as half of all Black respondents did identify this as a key factor for race and ethnicity.1
Patients and caregivers in this study also acknowledged their own health literacy as an important factor and did not feel that the responsibility for the facilitation of SDM was solely on the HCP. Approximately 92% of respondents said that their own health literacy, the ability to articulate their experience and feeling comfortable enough to do so were very important or absolutely essential for facilitating SDM. About 88% of respondents felt that these factors were usually or always true for them with their current eczema HCP.1
In this study, over 85% of patients reported it was important to not feel rushed during their appointment, and yet, around one third said this was an unmet need with their current HCP.1 Previous studies have shown that SDM in a dermatology encounter can effectively occur before, during or after a visit, and can take as little as 2–5 minutes, without adding overall time to the time already spent in routine discussions of treatment.9–13 This study also showed 42.4% of patients did not find in-person visits to be important for SDM.1 This may suggest the possibility for more patients and HCPs to utilize virtual visits when applicable.
Additionally, of the eczema patients and caregivers who reported that having an HCP initiate the discussion about treatment options is important/essential to them, 39% reported unmet need with their current HCP. Patients who feel equipped to discuss treatment options with a doctor they trust may additionally require an opening from the HCP to start the conversation.
A chronic condition like eczema requires dynamic SDM, which may involve several treatment decisions over time. Ideally, SDM results from an ongoing dialogue over many visits between a trusted HCP and a patient or caregiver who has health literacy and the tools to advocate for themselves. This study indicates that successful SDM is more likely to be facilitated when efforts to improve patient education and empowerment are coupled with HCPs who initiate treatment discussions, maintain compassion resilience and value patient perspectives.1
Additional findings and insights from this study are expected to be published soon.