Perspectives Of Healthcare Professionals Research Articles

Continuity of medication information transfer and continuous medication supply during hospital-to-home transitions - nationwide surveys in hospital and community pharmacies after implementing new legal requirements in Germany

BackgroundWhile successful information transfer and seamless medication supply are fundamental to medication safety during hospital-to-home transitions, disruptions are frequently reported. In Germany, new legal requirements came into force in 2017, strengthening medication lists and discharge summaries as preferred means of information transfer. In addition to previous regulations – such as dispensing medication at discharge by hospital pharmacies – hospital physicians were now allowed to issue discharge prescriptions to be supplied by community pharmacies. The aim of this survey study was to gain first nationwide insights into how these requirements are implemented and how they impact the continuity of medication information transfer and continuous medication supply.MethodsTwo nationwide self-administered online surveys of all hospital and community pharmacies across Germany were developed and conducted from April 17th to June 30th, 2023.ResultsOverall, 31.0% (n = 111) of all German hospital pharmacies and 4.5% (n = 811) of all community pharmacies participated. The majority of those hospital pharmacies reported that patients who were discharged were typically provided with discharge summaries (89.2%), medication lists (59.5%) and if needed, discharge prescriptions (67.6%) and/or required medication (67.6%). About every second community pharmacy (49.0%) indicated that up to half of the recently discharged patients who came to their pharmacy typically presented medication lists. 34.0% of the community pharmacies stated that they typically received a discharge summary from recently discharged patients at least once per week. About three in four community pharmacies (73.3%) indicated that most discharge prescriptions were dispensed in time. However, one-third (31.0%) estimated that half and more of the patients experienced gaps in medication supply. Community pharmacies reported challenges with the legal requirements – such as patients´ poor comprehensibility of medication lists, medication discrepancies, unmet formal requirements of discharge prescriptions, and poor accessibility of hospital staff in case of queries. In comparison, hospital pharmacies named technical issues, time/personnel resources, and deficits in patient knowledge of medication as difficulties.ConclusionAccording to the pharmacies´ perceptions, it can be assumed that discontinuation in medication information transfer and lack of medication supply still occur today during hospital-to-home transitions, despite the new legal requirements. Further research is necessary to supplement these results by the perspectives of other healthcare professionals and patients in order to identify efficient strategies.

Research priorities for medically not yet explained symptoms expressed by patients, carers, and healthcare professionals in the Netherlands following the James Lind Alliance priority setting partnership approach

ObjectiveExperiencing physical symptoms that are medically not yet explained (MNYES) is associated with considerable burden in daily life. Research priorities in this area have been primarily investigator-driven. The present study identifies the top 10 research priorities, incorporating the views of patients, carers and healthcare professionals. MethodsThis study used the Priority Setting Partnership approach in collaboration with the James Lind Alliance (JLA). The priority setting approach combines survey-based data from patients with a specific disorder/condition and relevant stakeholders (i.e., caregivers and healthcare professionals) with input from group meetings and a final priority setting consensus meeting. There were three consecutive phases: (1) online survey with an open-ended question to collect topics for future scientific research (N = 345 participants); (2) an online survey among stakeholders to prioritise the research questions generated in Phase 1 (N = 400); and (3) a final multi-stakeholder consensus meeting, held over two half-days to determine the final top 10 research priorities for the Netherlands (day 1 N = 25, day 2 N = 24). ResultsPhase 1 resulted in 572 topics, which were reduced to 37 summary research questions. Phase 2 resulted in 18 research priorities, that were ranked and the top 10 priorities were established during the final consensus meeting. The top 10 research priorities included three main themes: optimising efficient diagnosis and treatment, aetiology and prevention, and coping with MNYES. ConclusionThe top 10 priorities provide insight into what is most important for future research into MNYES from the perspective of patients, carers and healthcare professionals.

Diffusion of Innovation Theory Adaptation in Genomic-Based Product Marketing Strategy

With the rise of preventative healthcare needs after the COVID-19 pandemic, tanyaDNA, a genomics company in Indonesia, seeks to introduce Lifestyle and Pharmacogenomic Testing. This study explores using Diffusion of Innovation Theory to create a targeted marketing strategy for this new service. There's a lack of awareness and affordability concerns surrounding the test, along with a knowledge gap between the company, healthcare professionals, and the target market. The research aims to assess the theory's applicability, bridge these understanding gaps, and promote successful integration of the test into Indonesian healthcare. This can inform marketing strategies for other genomics companies looking to expand beyond COVID-19 testing. The study focuses on the JABODETABEK area of Indonesia and utilizes surveys and interviews to gather data. The findings can help bridge the gap between product creators and target markets, especially regarding the perspectives of key healthcare professionals.

Development and early implementation of telemonitoring of complicated pregnancies – A qualitative study with the perspectives of health professionals

BackgroundTelemonitoring may offer promising opportunities in health care. In obstetric health care, there is a need to expand and improve digitalization. Nevertheless, there is limited knowledge based on healthcare professionals' perspectives regarding the use of telemedicine and remote cardiotocography during pregnancy, as well as its implementation. AimTo explore the perspectives of health-care professionals who manage telemonitoring of complicated pregnancies. Design and settingA qualitative interview study undertaken in a hospital with a tertiary obstetric unit in Northen Denmark. MethodsBased on a purposive sample strategy, 11 semi-structured interviews of health-care professionals involved in the management of telemonitoring in women with complicated pregnancies were conducted and analyzed using a reflexive thematic analytical approach. FindingsThe findings are assembled into two main themes. The experience of relevance to own practice: included the embedded potentials in telemonitoring providing women-centred care, but also challenges related to the implementation of a new technology. Experience of challenges and potential in day-to-day operation: included frustrations regarding the technological devices and software, working experiences increasing confidence in telemonitoring, and perspectives on the required interdependence across departments. ConclusionThis study adds important knowledge to support awareness and reflection on how challenges impact the successful implementation of telemonitoring in obstetric and midwifery care. This includes knowledge of important processes and resources to ensure ongoing implementation and evaluation. Implementation strategies and collaborations to support a multiple-level system change, such as an interdisciplinary team, seem crucial to minimize challenges, build shared visions, and engage staff.

Multidisciplinary Perspectives on Medical Decision-Making for Ostomy Surgery in Pediatric IBD: Themes from Focus Groups.

Pediatric Inflammatory Bowel Disease (IBD) is a chronic illness where patients may undergo ostomy surgery. Medical decision-making (MDM) for ostomy surgery is complex for patients/families and multidisciplinary healthcare professionals (HCPs) alike, with current uncertainty about how multidisciplinary HCPs think about ostomy care to inform future interventions to facilitate equitable multidisciplinary care for patients. This study sought to understand pediatric IBD multidisciplinary HCPs' perceptions regarding ostomy-related MDM and education. Multidisciplinary HCPs (e.g., gastroenterology medical providers, social workers, surgeons, and ostomy nurses) participated in semi-structured focus groups. Focus group data underwent qualitative analysis to identify themes. Three multidisciplinary focus groups were conducted, with n = 12 participants across all groups. Qualitative analysis identified three main themes, including (1) HCP perceptions of ostomies, (2) Patient/family-related factors, and (3) Professional roles and collaboration challenges. Ostomy surgery in pediatric IBD requires complex multidisciplinary MDM and education. Perspectives of multidisciplinary HCPs identified patient, HCP, and systems factors that may impact MDM for ostomy surgery. This work highlights nuances in MDM and education in IBD, and the critical role of ongoing research and improved standardized processes to coordinate multidisciplinary ostomy-related MDM and education in this population.

Therapeutic Obstinacy in End-of-Life Care-A Perspective of Healthcare Professionals from Romania.

End-of-life care raises ethical, moral, legal and economic dilemmas, especially when physicians have to decide whether to initiate or to stop treatments that may be considered disproportionate and futile. To explore the opinion of health care professionals involved in end-of-life patient care on interventions considered disproportionate and futile at this stage of care, the causes and factors of pressure leading to such situations, and possible solutions to reduce the phenomenon. The study used an adapted, designed questionnaire intended for health professionals caring for patients at the end of life. The 128 respondents were physicians, nurses, psychologists and social workers who expressed their opinions about therapeutic obstinacy in end-of-life care. The results of the research highlight the role of the family as a pressure factor, the causes related to the non-acceptance of the prognosis and diagnosis of a terminal condition, fear of death and ignorance of the patient's wishes. Interventions considered disproportionate at the end of life were cardiopulmonary resuscitation, mechanical ventilation, transfusion of blood derivatives, complex diagnostic investigations and the establishment of gastrostomy/jejunostomy in the last days of life. End-of-life therapeutic obstinacy is a reality in end-of-life care, and healthcare professionals face many ethical challenges in this process. Care decisions must be made together with the patient and their family, respecting the rights, dignity and respect of all parties involved in the process.

Knowledge, Beliefs, and Experiences With Mental Health Services and Help-Seeking in People With Aphasia and Care Partners.

Supporting psychological well-being in persons with aphasia (PWA) can improve social and health outcomes; however, PWA and their care partners (CPs) are often not receiving mental health support. Previous research explores this from the perspective of health care professionals. The aim of this study was to examine knowledge, beliefs, and experiences related to mental health services directly from PWA and CPs. The study included 11 PWA and 11 CPs. Participants completed a guided survey (virtual) with opportunities for elaboration related to the knowledge, beliefs, and experiences of mental health. There was variability in personal preferences for referrals, types of coping strategies, and confidants for general thoughts and feelings and those specific to aphasia. PWA identified health care professionals as people to share thoughts and feelings, whereas CPs chose family and friends more often. Both CPs and PWA reported communication difficulty and finding a counselor as "sometimes" preventing access to services but cited fear and trust as "always" preventing access. Knowledge, beliefs, and experience with help-seeking and mental health services are personal and variable. Assessing barriers unique to living with aphasia, such as communication challenges and locating a suitable counselor, must also be considered within more complex and personal barriers of fear and trust that are consistently reported in the general public. Health professionals across the continuum of aphasia care need to understand the communication challenges of living with aphasia in tandem with understanding individual differences to personalize approaches to mental health services and help-seeking.

Implementation of a digital distress detection system in palliative care: qualitative data on perspectives of a multiprofessional palliative care team

BackgroundDigital health technologies such as sensor systems are intended to support healthcare staff in providing adequate patient care. In the Department of Palliative Medicine (University Medical Center Freiburg), we developed and implemented a noninvasive, bed-based sensor system in a pilot study. The aim was to detect distress in patients who were no longer able to express themselves by monitoring heart and respiratory rates, vocalizations, and movement measurements. The sensor system was intended to supplement standard care, which generally cannot guarantee constant monitoring. As there is a lack of data on how healthcare professionals experience such a techno-digital innovation, the aim of this study was to explore how the multiprofessional palliative care team who piloted the sensor system perceived its potential benefits and limitations, and how they experienced the broader context of healthcare technology and research in palliative care.MethodsWe conducted a qualitative interview study with 20 members of the palliative care team and analyzed the recorded, verbatim transcribed interviews using qualitative content analysis.ResultsThe sensor system was described as easy to use and as helpful support for patients, care staff, and relatives, especially against the backdrop of demographic change. However, it could not replace human interpretation of stress and subsequent treatment decisions: this remained the expertise of the nursing staff. A potential reduction in personnel was expected to be a risk of a digital monitoring system. The special conditions of research and digital health technologies in an end-of-life context also became clear. Specifically, healthcare staff were open to health technologies if they benefited the patient and were compatible with professional nursing and/or palliative care attitudes. Additionally, a patient-protective attitude and possible interprofessional differences in priorities and the resulting challenges for the team became apparent.ConclusionsA potential digital solution for distress monitoring was considered useful by palliative care practitioners. However, interprofessional differences and compatibility with existing palliative care practices need to be considered before implementing such a system. To increase user acceptability, the perspectives of healthcare professionals should be included in the implementation of technological innovations in palliative care.

A survey of patients with cancer and oncology health-care professionals about cannabis use during treatment.

This study characterizes patient and health-care professional perspectives regarding medical cannabis use at a National Cancer Institute-Designated Cancer Center. Data evaluated included the prevalence and patterns of and reasons for cannabis use. Patients with cancer undergoing treatment were recruited into a cross-sectional survey as part of a national National Cancer Institute-funded effort. Participants completed a survey about cannabis use, reasons for use, and types of cannabis. A health-care professional survey was also conducted to explore perspectives regarding patients' use of cannabis. A total of 313 patients with cancer (mean [SD] age = 60.7 [12.8] years) completed the survey (43% response rate) between 2021 and 2022. Of the respondents, 58% were female; identified as White (61%) and Black (23%); and had diverse cancer diagnoses. Nearly half of respondents (43%) had previously used cannabis, one-quarter (26%) had used cannabis since their cancer diagnosis, and almost 1 in 6 (17%) were actively using cannabis at the time of survey completion. The most common modes of ingestion were gummies (33%) and smoking (30%). The most commonly reported reasons for use were insomnia (46%), pain (41%), and mood (39%). For the 164 health-care professionals who completed the survey (25% response rate), the majority agreed that cannabis use (72%) is safe and beneficial for patients (57%). Four in 10 (39%) health-care professionals felt comfortable providing guidance to patients about cannabis use; however, only 1 in 8 (13%) felt knowledgeable about the topic of cannabis. Approximately one-sixth of patients with cancer receiving treatment actively use cannabis for management of various cancer symptoms. Perceptions about cannabis use and education varied widely among health-care professionals.

Understanding AI in Healthcare: Perspectives of Future Healthcare Professionals.

Introduction The current medical curriculum lacks comprehensive artificial intelligence (AI)-focused training, potentially impacting future healthcare delivery. This study addresses the critical gap in AI training within medical education, particularly in India, by assessing medical students' awareness, perceptions, readiness, confidence, and ethical considerations regarding AI in healthcare. Our findings underscore the necessity of integrating AI competencies into medical education to prepare future healthcare professionals for an AI-driven landscape. Method After obtaining ethics approval, we conducted a cross-sectional study on Bachelor of Medicine andBachelor of Surgery(MBBS) students from the 2019-2023 batch. An exploratory survey using a validated questionnaire was employed to obtain medical students' current understanding and awareness of artificial intelligence (AI) in healthcare, perceptions, readiness,confidence, andethical considerations in utilizing AI technologies in clinical practice. Results The survey received 217 responses from 2019-2023 MBBS students. We found a mean percentage of awareness score of 44.74%, a mean percentage perception score of 68.96%, a mean percentage readiness score of 91.32%, a mean percentage confidence score of 58.48%, and a mean percentage ethics importance score of 69.27%. Males had higher awareness, confidence, and readiness scores. Conversely, females scored slightly higher in perception and the importance of ethics consideration, although not statistically significant. Junior batches outperform senior batches in perception, confidence, and readiness scores; in contrast, the awareness and ethics importance scores do not show significant differences between the two groups. Conclusion Our study indicates a generally positive outlook towardAI's potential to enhance healthcare delivery and patient outcomes. The study suggests a strong inclination towardfurther education and practical training focused on AI in healthcare, considering a solid recognition of the significance of ethical implications related to AI in healthcare. These findings highlight the importance of fostering AI literacy within medical education curricula and underscore the necessity for ongoing evaluation and adaptation to ensure that future healthcare professionals are equipped to navigate the complexities of AI in healthcare delivery while upholding ethical standards.

Utilizing online reviews for analyzing digital healthcare consultation services: Examining perspectives of both healthcare customers and healthcare professionals

IntroductionDigital healthcare consultation services, also known as telemedicine, have seen a surge in their usage, especially after the COVID-19 pandemic. The purpose of this study is to investigate the satisfaction determinants of healthcare customers (patients) and healthcare professionals (doctors), providing digital healthcare consultation services. MethodsThe analysis involved scraping online reviews of 11 telemedicine apps meant for patients and 7 telemedicine apps meant for doctors, yielding a total of 44,440 patient reviews and 4748 doctor reviews. A structural topic modeling analysis followed by regression, dominance, correspondence, and emotion analysis was conducted to derive insights. ResultsThe study identified ten determinants of satisfaction from patients’ and eight from doctors’ perspectives. For patients, ’service variety and quality’ (β = 0.5527) was the top positive determinant, while ’payment disputes’ (β = -0.1173) and ’in-app membership’ (β = -0.031) negatively impacted satisfaction. For doctors, ’patient consultation management’ (β = 0.2009) was the leading positive determinant, with ’profile management’ (β = -0.1843), ’subscription’ (β = -0.183), and ’customer care support’ (β = -0.0908) being the negative ones. The most influential negative emotion for patients, anger, was closely associated with ’customer care service’ and ’in-app memberships,’ while joy was tied to ’service variety and quality’ and ’offers and discounts.’ For doctors, anger was associated with ’cost-effectiveness,’ and joy with ’app responsiveness.’ ConclusionThis study offers new insights by examining patient and doctor determinants at a granular level which can be used by telemedicine app developers and managers to build customer-centric services.

Addressing the unmet care needs of people with hidradenitis suppurativa.

Hidradenitis suppurativa (HS) can have a devastating impact on patients’ lives. Challenges and unmet needs in the management of HS can further exacerbate low wellbeing and poor quality of life among patients. This article provides the perspectives of patients and healthcare professionals on these challenges and provides suggestions for how clinicians can help ensure patients with HS receive the care they need.

Professionals' and Intercultural Mediators' Perspectives on Communication With Ukrainian Refugees in the Czech Healthcare System.

A growing body of research is examining how healthcare systems are responding to the increasing numbers of migrants and the resulting superdiversity of patients. The aim of this article is to identify and explain communication barriers in the provision of healthcare to Ukrainian war refugees in the Czech Republic from the perspectives of healthcare professionals and intercultural mediators. The exploratory case study is based on a qualitative analysis of semi-structured interviews with frontline health professionals: 20 with doctors and 10 with nurses. The second source of data is two focus groups aimed at capturing communication problems from the perspective of intercultural mediators who accompany refugees to health facilities. The interview transcripts and FGs were analysed using six-stage thematic coding. The survey identified five main themes related to barriers to communication: (1) language barriers and interpreting, (2) cultural barriers, (3) differing expectations of health and the healthcare systems in the Czech Republic and Ukraine, (4) prejudices and negative attitudes and unethical behaviour towards refugees and migrants and (5) lack of awareness of patient rights. The arrival of large numbers of migrants has highlighted deficiencies in the system that may affect other vulnerable groups and the general population. These include the lack of general communication skills and legal awareness among many health professionals, which are barriers to the development of patient-centred care. The involvement of intercultural mediators fundamentally improves communication between health professionals and (not only) migrant patients. Nevertheless, it is necessary to legally anchor and define the position of intercultural mediators within the healthcare system. Collaboration with intercultural mediators who interpreted the extensive experiences of Ukrainian refugee patients and also have personal experience as migrant or migrant-origin patients contributed to shaping research questions, facilitating study participation and enriching evidence interpretation. Researchers with multicultural backgrounds and experience with working with people from refugee backgrounds were involved in the study design and analysis.

Healthcare Professional Perspectives on the Impact of the Physical Health Nurse Consultant.

Early mortality experienced by people living with mental health issues (hereon termed consumers) is largely preventable. Healthcare professionals perceive healthcare system inadequacies such as diagnostic overshadowing, stigma and fragmentation of physical and mental healthcare services can be resolved through effective integration approaches. Service- and individual-level integration approaches involve multidisciplinary teams collaborating and coordinating care to holistically meet consumers' physical and mental health needs. Evidence suggests appropriately trained healthcare professionals can deliver effective integrated treatment without financial or organisational restructuring. Specialist nursing positions such as Physical Health Nurse Consultants can support and integrate physical and mental health care. Consumers report the Physical Health Nurse Consultant as providing dedicated, integrated, coordinated and holistic mental and physical health care. This study aimed to explore the Physical Health Nurse Consultant role from the perspectives of healthcare professionals. A qualitative exploratory study design was used. Fourteen healthcare professionals participated in individual interviews or focus groups. Interview recordings were transcribed, and thematically analysed. Three themes were identified: (i) role functions, including integration of physical and mental health care, (ii) impact on consumer physical health outcomes and (iii) impact on service delivery. Healthcare professionals perceive the Physical Health Nurse Consultant effectively integrates physical and mental health care and subsequently support the continuation and embedding of the role in routine practice. Future research is required to explore healthcare professionals' experiences and perceptions of how these roles be translated to routine clinical practice. Examining the professional development requirements, service provider constraints and economic implication to achieve these outcomes also warrants attention.

Information work and digital support during the perinatal period: Perspectives of mothers and healthcare professionals.

During pregnancy and early motherhood, the perinatal period, women use a variety of resources including digital resources to support social interactions, information seeking and health monitoring. While previous studies have investigated specific timepoints, this study takes a more holistic approach to understand how information needs and resources change over the perinatal period. Furthermore, we include the perspective of maternity healthcare professionals to better understand the relationship between different stakeholders in the information work of perinatal women. A total of 25 interviews with 10 UK based mothers and 5 healthcare professionals (3 Midwives and 2 Health visitors) were conducted. Perinatal women were asked about their information and support needs throughout pregnancy and the postnatal period, healthcare professionals were asked about information and support provision to perinatal women. Information work activities were grouped along stages of the perinatal timeline from pre-pregnancy to the postanal period to illustrate the work and perspectives of the women and the healthcare professionals. Information work varies considerably over the timeline of the perinatal period, shifting back and forth in focus between mother and baby. information work during this period consists of many information related activities including seeking, monitoring, recording, questioning, sharing and checking. The importance of the HCPs as stakeholders in this work is notable as is the digital support for information work. Importantly, paper-based resources are still an important shared resource allowing reflection and supporting communication. Information work for women varies across the perinatal timeline. Particular challenges exist at key transition points, and we suggest design considerations for more integrated digital resources that support information work focused on mother and baby to enhance communication between perinatal women and healthcare professionals.

A Qualitative Exploration of Cardiovascular Disease and Stroke Prevention Educational Needs of Culturally and Linguistically Diverse Communities: Perspectives of Healthcare Professionals and Stakeholders

A Qualitative Exploration of Cardiovascular Disease and Stroke Prevention Educational Needs of Culturally and Linguistically Diverse Communities: Perspectives of Healthcare Professionals and Stakeholders

Understanding Patients' Heart Health Knowledge: Perspectives of Cardiac Patients and Healthcare Professionals in Aotearoa New Zealand

Understanding Patients' Heart Health Knowledge: Perspectives of Cardiac Patients and Healthcare Professionals in Aotearoa New Zealand

The elements of end-of-life care provision in paediatric intensive care units: a systematic integrative review

BackgroundDeaths in paediatric intensive care units (PICUs) are not uncommon. End-of-life care in PICUs is generally considered more challenging than other settings since it is framed within a context where care is focused on curative or life-sustaining treatments for children who are seriously ill. This review aimed to identify and synthesise literature related to the essential elements in the provision of end-of-life care in the PICU from the perspectives of both healthcare professionals (HCPs) and families.MethodsA systematic integrative review was conducted by searching EMBASE, CINAHL, MEDLINE, Nursing and Allied Health Database, PsycINFO, Scopus, Web of Science, and Google Scholar databases. Grey literature was searched via Electronic Theses Online Service (EthOS), OpenGrey, Grey literature report. Additionally, hand searches were performed by checking the reference lists of all included papers. Inclusion and exclusion criteria were used to screen retrieved papers by two reviewers independently. The findings were analysed using a constant comparative method.ResultsTwenty-one studies met the inclusion criteria. Three elements in end-of-life care provision for children in the PICUs were identified: 1) Assessment of entering the end-of-life stage; 2) Discussion with parents and decision making; 3) End of life care processes, including care provided during the dying phase, care provided at the time of death, and care provided after death.ConclusionThe focus of end-of-life care in PICUs varies depending on HCPs’ and families’ preferences, at different stages such as during the dying phase, at the time of death, and after the child died. Tailoring end-of-life care to families’ beliefs and rituals was acknowledged as important by PICU HCPs. This review also emphasises the importance of HCPs collaborating to provide the optimum end-of-life care in the PICU and involving a palliative care team in end-of-life care.

Responding to the needs of survivors of intimate partner violence in Lithuania: perceptions of mental health and social care professionals

ABSTRACT Around eight-out-of-ten survivors of domestic violence in Lithuania are women, and of those, eight-out-of-ten suffer violence specifically from their intimate partners (IPV). Women who experience IPV are at higher risk of having mental health conditions. This study aims to explore the perspectives of mental health and social care professionals regarding the provision of mental health support to IPV survivors in Lithuania. Four focus groups were conducted among 29 service providers from across the country. Audio-recordings were transcribed verbatim and analyzed thematically using MAXQDA software. The five main themes derived from the analysis reveal: 1) low levels of IPV awareness among IPV survivors who seek support with their mental health; 2) a lack of specialized training among professionals as a barrier to effective support; 3) a low prioritization on the national level; 4) little inter-sectoral collaboration which undermines the complexity of needed responses; 5) broader systemic problems. The provision of mental health support to IPV survivors lacks the recognition that IPV is gender-based violence and a major public (mental) health problem. The complexity of needed services is absent. Further research needs to explore the utilization of mental health services by IPV survivors and their perceptions concerning it.

Atopic Dermatitis Treatment with Topical Therapy Alone Results in Persistent Elevated Disease Severity and High Disease Control Dissatisfaction: Real-World Health Care Professional and Patient Perspectives

Background: Given the changing treatment landscape in atopic dermatitis (AD), it is important to understand real-world disease severity and health care professional (HCP) and patient treatment expectations and goals. This study assesses HCP-reported current disease severity and rates of HCP and patient dissatisfaction with current disease control in patients with a history of moderate-to-severe AD. Methods: This study was an analysis of data from the United States Adelphi AD Disease Specific Programme™, a cross-sectional, descriptive, real-world study of HCP-completed medical records and patient surveys including retrospective data. The study included patients with a current diagnosis or a history of moderate-to-severe AD. HCPs provided information on current AD severity and treatments. Both HCPs and patients provided information on satisfaction with disease control on current treatment, and reasons for any dissatisfaction. Patients were stratified by their current treatment (systemic + topicals, systemic only, or topicals only). Systemic treatments included injectable biologics, oral small molecules, oral and injected corticosteroids, and immunosuppressants; topical treatments included corticosteroids, calcineurin inhibitors, crisaborole, and ruxolitinib. Results A total of 146 HCPs (70 dermatologists, 19 allergists/immunologists, and 57 primary care practitioners) provided data for 747 patients, 215 of whom filled out a patient survey. Based on defined systemic and topical treatments, there were 191 (26%) patients on systemic + topical therapy, 143 (19%) patients on systemics only, and 200 (27%) patients on topicals only. Dissatisfaction rates for AD disease control on current treatment were reported by HCPs and patients for systemic + topicals [20%, 21%], systemic only [10%, 11%], and topicals only [23%, 30%]). The most common reasons for patient dissatisfaction with AD control were the “constant problem of itch,” “lack of clear skin,” “skin lesions that were visible to other people,” and “unresolved flaring.” Despite extended mean treatment duration (MTD), HCPs reported current moderate-to-severe disease severity in 64% of patients on systemic + topicals (MTD 496 days), 50% on systemics only (MTD 456 days), and 61% on topicals only (MTD 268 days). Conclusion: These descriptive results suggest that many patients still have moderate-to-severe AD despite available treatments. A higher proportion of HCPs and patients were dissatisfied with the current level of disease control when topical therapies alone were prescribed. Patient dissatisfaction with disease control was due to itch, lack of clear skin, visible skin lesions, and flares.