Factors facilitating shared decision making in eczema: Met and unmet needs from the patient perspective

JAAD Int. 2023 Feb 2:11:95-102. doi: 10.1016/j.jdin.2022.12.008. eCollection 2023 Jun.

Abstract

Background: Research has shown that eczema patients prefer some degree of shared control over treatment decisions, but little is known about factors perceived to be important to facilitate shared decision making (SDM).

Objective: To determine factors eczema patients and caregivers consider to be important for SDM, and how often they experience them with their eczema healthcare provider (HCP).

Methods: A cross-sectional survey study (64 questions) was conducted, which included factors related to SDM rated by respondents on a Likert scale for importance, and how often these factors were true with their current eczema HCP.

Results: Respondents (840, response rate 62.4%) most frequently rated their health literacy and communication skills as important for SDM. Factors which indicated a strong provider-patient relationship, and HCPs who initiate treatment conversations were also deemed beneficial. Low importance was placed on concordant HCP race/ethnicity, however, of those who did rate it as important, 53/91 identified as Black (half of all Black respondents).

Limitations: A high proportion of respondents were aware of the term SDM prior to the survey.

Conclusions: SDM is more likely to be facilitated when patient education and empowerment are coupled with HCPs who initiate treatment discussions, maintain compassion resilience, and listen to patient perspectives.

Keywords: HCP, healthcare provider; NEA, National Eczema Association; PDA, patient decision aid; SDM, shared decision making; atopic dermatitis; eczema; patient care; patient-provider relationship; shared decision-making; treatment decisions.