Taliercio Vanina L, Snyder Ashley M, Biggs Allison M, Kean Jacob, Hess Rachel, Duffin Kristina Callis, Cizik Amy M, Secrest Aaron M
Department of Dermatology, University of Utah, 30 N 1900 East, 4A330, Salt Lake City, UT, 84132, USA.
Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
Qual Life Res. 2022 Jun;31(6):1719-1725. doi: 10.1007/s11136-021-03030-w. Epub 2021 Nov 2.
Skin conditions can have profound negative symptomatic and psychological effects. Failure to address these effects can lead to poor treatment adherence and/or patient dissatisfaction. Despite patient-reported outcome (PRO) use being highly recommended, real-world adoption has been slow.
To assess clinicians' perceived facilitators and barriers to using PROs in daily practice.
We conducted in-person semi-structured interviews with 19 clinicians and thematic analysis of transcripts.
Three main themes emerged: (1) clinicians' attitudes about the value of Skindex-16 in daily practice, (2) patient attitudes influencing clinicians' use of Skindex-16, and (3) clinicians' perceptions of their ability to use PROs successfully for clinical care. Clinicians recognized benefits to using Skindex-16, such as revealing patients' hidden concerns and highlighting discrepancies with the clinician's severity assessments. Conversely, clinicians also identified limitations, such as time constraints and lack of relevance for some skin conditions. Patient complaints about PRO relevance have influenced clinicians' use of Skindex-16 negatively. Finally, some clinicians recognized the need for more training in score interpretation and implementation strategies for optimal clinical flow.
While most clinicians believed PROs like Skindex-16 can be useful for patient care, barriers need to be addressed to make PROs more practical for routine clinical care.
皮肤疾病可产生严重的负面症状及心理影响。未能解决这些影响可能导致治疗依从性差和/或患者不满。尽管强烈推荐使用患者报告结局（PRO），但在现实世界中的应用进展缓慢。
评估临床医生在日常实践中使用PRO的感知促进因素和障碍。
我们对19名临床医生进行了面对面的半结构化访谈，并对访谈记录进行了主题分析。
出现了三个主要主题：（1）临床医生对Skindex-16在日常实践中的价值的态度，（2）影响临床医生使用Skindex-16的患者态度，以及（3）临床医生对其成功将PRO用于临床护理能力的认知。临床医生认识到使用Skindex-16的益处，如揭示患者隐藏的担忧并突出与临床医生严重程度评估的差异。相反，临床医生也指出了局限性，如时间限制以及对某些皮肤疾病缺乏相关性。患者对PRO相关性的抱怨对临床医生使用Skindex-16产生了负面影响。最后，一些临床医生认识到需要在评分解读和实施策略方面接受更多培训，以实现最佳临床流程。
虽然大多数临床医生认为像Skindex-16这样的PRO对患者护理有用，但需要解决相关障碍，以使PRO在常规临床护理中更具实用性。
