Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, PO Box 80082, 3508 TB, Utrecht, The Netherlands.
Department of Pharmaceutical Care, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium.
Int J Clin Pharm. 2019 Jun;41(3):711-718. doi: 10.1007/s11096-019-00827-1. Epub 2019 Apr 24.
Background Atopic dermatitis affects 10-20% of the children worldwide. Unfortunately not all patients who receive treatment have optimal treatment outcomes. Objective To assess the view of parents and pharmacy staff in order to optimize pharmaceutical care for young atopic dermatitis patients. Setting Community pharmacies in the Netherlands. Method We first held an expert panel meeting to determine experts' views on treatment of atopic dermatitis and their suggestions for areas of improvement. This input was used to develop the interview guide. We conducted telephone interviews with parents of children (aged 0-12 years) with atopic dermatitis and face-to-face interviews with pharmacy staff members. All interviews were audiotaped and transcribed verbatim. Transcripts were coded using qualitative data analysis software. Codes were used to identify themes. Main outcome measure Perspectives of parents of young atopic dermatitis patients and pharmacy staff about treatment. Results We interviewed 29 parents and 18 pharmacy staff members. Many parents mentioned fear of steroid adverse effects, with intentional nonadherence as a consequence, and difficulties with the application of topical treatment. Pharmacy employees also mentioned to encounter these issues. Some employees themselves expressed concerns towards use of steroids. Most parents were satisfied with the information they received; however, they need more practical lifestyle advices, e.g. about bathing or clothing. Both pharmacists and pharmacy technicians mentioned that technicians often lack knowledge to support patients optimally in correct medication use. Conclusion Parents' perceptions about topical corticosteroids might negatively influence treatment outcomes. Pharmacy staff has an important role to inform parents of children with eczema on the appropriate use of topical corticosteroids and emollients. Counseling should not be influenced by their own prejudices about topical corticosteroids. Close collaboration between primary care providers should ensure that parents receive uniform messages.
特应性皮炎影响全球 10-20%的儿童。不幸的是，并非所有接受治疗的患者都能获得最佳的治疗效果。目的：评估家长和药剂师的观点，以优化针对年轻特应性皮炎患者的药物治疗。地点：荷兰社区药房。方法：我们首先举行了一次专家小组会议，以确定专家对特应性皮炎治疗的看法及其对改进领域的建议。这一投入被用于制定访谈指南。我们对患有特应性皮炎的儿童（0-12 岁）的家长进行了电话访谈，并与药剂师进行了面对面访谈。所有访谈都进行了录音，并逐字记录。使用定性数据分析软件对抄本进行编码。使用代码识别主题。主要结果措施：年轻特应性皮炎患者家长和药剂师对治疗的看法。结果：我们采访了 29 位家长和 18 位药剂师。许多家长提到了对皮质类固醇不良反应的恐惧，因此故意不遵守医嘱，并且在应用局部治疗方面存在困难。药剂师也提到了遇到这些问题。一些员工自己也对使用类固醇表示担忧。大多数家长对他们收到的信息感到满意；然而，他们需要更多关于生活方式的实用建议，例如关于洗澡或穿衣的建议。药剂师和药剂技术员都提到，技术人员往往缺乏知识，无法在正确使用药物方面为患者提供最佳支持。结论：家长对局部皮质类固醇的看法可能会对治疗结果产生负面影响。药剂师在为患有湿疹的儿童提供有关正确使用局部皮质类固醇和保湿剂的信息方面发挥着重要作用。咨询不应受到他们对局部皮质类固醇的偏见的影响。初级保健提供者之间的密切合作应确保家长获得统一的信息。
