Optimizing Communication About Topical Corticosteroids: A Quality Improvement Study

Area of Science:

• Dermatology
• Medical Communication
• Quality Improvement

Background:

• Patient non-adherence to topical corticosteroids (TCS) is a significant clinical challenge.
• Poor communication between dermatologists and patients may contribute to TCS non-adherence.

Purpose of the Study:

• To describe dermatologist-patient communication patterns regarding TCS treatments.
• To compare communication before and after implementing an educational intervention.

Main Methods:

• A quality improvement study involving audiotaped encounters between dermatologists and new outpatients receiving TCS prescriptions.
• An intervention comprising a patient educational pamphlet and a dermatology team communication workshop.
• Communication analysis using the MEDICODE system, comparing pre- and post-intervention phases.

Main Results:

• Pre-intervention, dermatologists frequently discussed medication information but rarely patient experience themes (e.g., treatment goals, adverse effects, patient emotions).
• Post-intervention, discussion of patient experience themes increased without extending consultation length.
• In both phases, communication was largely monologistic, with limited patient verbal input.

Conclusions:

• The study highlights areas for improving dermatologist communication regarding TCS, particularly concerning adverse effects and patients' emotional responses.
• Enhanced communication is crucial for improving patient understanding and adherence to TCS treatments.