The challenges of facilitating primary healthcare discussions on traditional,complementary and alternative medicine for childhood eczema: Piloting a computerized template |
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| Institution: | 1. London South Bank University, London, UK;2. Formerly Thames Valley University, London, UK;3. Imperial College, London, UK;1. The Institute of Dermatology and Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei City, China;1. Institut Curie, Centre de Recherche, Team TGF-β and Oncogenesis, Orsay, France;2. Institut National de la Santé et de la Recherche Médicale, Unit U1021, Orsay, France;3. Le Centre National de la Recherche Scientifique, Unités Mixtes de Recherche 3347, Orsay, France;4. Ligue Nationale Contre le Cancer, Programme Carte d’Identité des Tumeurs, Paris, France;1. Department of Dermatology, China-Japan Friendship Hospital, Beijing, China;2. Institute of Dermatology and Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei, China;3. Graduate School of Peking Union Medical College, Beijing, China;1. Gladstone Hospital, Central Queensland Hospital and Health Service, Gladstone, Queensland, Australia;2. University of Queensland, Northside Clinical School, Brisbane, Queensland, Australia;3. Redcliffe Hospital, Metro North Hospital and Health Service, Redcliffe, Queensland, Australia |
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| Abstract: | ObjectiveHealthcare practitioners (HCPs) experience barriers to changing routine consultation practice. Communication and recording of traditional, complementary and alternative medicines (TCAM) is inadequate. This pilot study explored the challenges of implementing a computerized template in primary care to facilitate communication on TCAM for paediatric eczema.MethodsA computerized template to record TCAM use, with links to evidence-based TCAM databases, was designed, based on qualitative research with patients and HCPs. Four London general practices implemented the template integrated with usual practice. Twelve focus groups during the 6 month study period explored HCPs’ knowledge, communication and information sources regarding TCAM and perceived barriers to template implementation.ResultsHCPs were initially enthusiastic about discussing TCAM, for improving communication and understanding patient's choices, but the template was used in under a third of consultations. HCPs were surprised at low TCAM use (10%) and lack of correlation with eczema or ethnicity. Reported barriers were time and remembering, due to busy, target-driven practice.ConclusionHCPs recognize the importance of discussing TCAM use for childhood eczema, and potential benefits for HCP–patient communication.Practice implicationsFuture tools to facilitate TCAM discussion should prioritise use of existing IT systems and address barriers to use, especially lack of time. |
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