TY - JOUR
T1 - Values and Preferences of Patients and Caregivers Regarding Treatment of Atopic Dermatitis (Eczema)
T2 - A Systematic Review
AU - Maleki-Yazdi, Keon Andre
AU - Heen, Anja Fog
AU - Zhao, Irene X.
AU - Guyatt, Gordon H.
AU - Suzumura, Erica A.
AU - Makhdami, Nima
AU - Chen, Lina
AU - Winders, Tonya
AU - Wheeler, Kathryn E.
AU - Wang, Julie
AU - Spergel, Jonathan
AU - Silverberg, Jonathan I.
AU - Ong, Peck Y.
AU - O'Brien, Monica
AU - Martin, Stephen A.
AU - Lio, Peter A.
AU - Lind, Mary Laura
AU - Lebovidge, Jennifer
AU - Kim, Elaine
AU - Huynh, Joey
AU - Greenhawt, Matthew
AU - Frazier, Winfred T.
AU - Ellison, Kathy
AU - Capozza, Korey
AU - De Benedetto, Anna
AU - Boguniewicz, Mark
AU - Begolka, Wendy Smith
AU - Asiniwasis, Rachel Netahe
AU - Schneider, Lynda C.
AU - Chu, Derek K.
N1 - Publisher Copyright: © 2023 American Medical Association. All rights reserved.
PY - 2023/3/15
Y1 - 2023/3/15
N2 - Importance: Patient values and preferences can inform atopic dermatitis (AD) care. Systematic summaries of evidence addressing patient values and preferences have not previously been available. Objective: To inform American Academy of Allergy, Asthma & Immunology (AAAAI)/American College of Allergy, Asthma and Immunology (ACAAI) Joint Task Force on Practice Parameters AD guideline development, patient and caregiver values and preferences in the management of AD were systematically synthesized. Evidence Review: Paired reviewers independently screened MEDLINE, Embase, PsycINFO, and CINAHL databases from inception until March 20, 2022, for studies of patients with AD or their caregivers, eliciting values and preferences about treatment, rated risk of bias, and extracted data. Thematic and inductive content analysis to qualitatively synthesize the findings was used. Patients, caregivers, and clinical experts provided triangulation. The GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research) informed rating of the quality of evidence. Findings: A total of 7780 studies were identified, of which 62 proved eligible (n = 19442; median age across studies [range], 15 years [3-44]; 59% female participants). High certainty evidence showed that patients and caregivers preferred to start with nonmedical treatments and to step up therapy with increasing AD severity. Moderate certainty evidence showed that adverse effects from treatment were a substantial concern. Low certainty evidence showed that patients and caregivers preferred odorless treatments that are not visible and have a minimal effect on daily life. Patients valued treatments capable of relieving itching and burning skin and preferred to apply topical corticosteroids sparingly. Patients valued a strong patient-clinician relationship. Some studies presented varied perspectives and 18 were at high risk for industry sponsorship bias. Conclusions and Relevance: In the first systematic review to address patient values and preferences in management of AD to our knowledge, 6 key themes that may inform optimal clinical care, practice guidelines, and future research have been identified..
AB - Importance: Patient values and preferences can inform atopic dermatitis (AD) care. Systematic summaries of evidence addressing patient values and preferences have not previously been available. Objective: To inform American Academy of Allergy, Asthma & Immunology (AAAAI)/American College of Allergy, Asthma and Immunology (ACAAI) Joint Task Force on Practice Parameters AD guideline development, patient and caregiver values and preferences in the management of AD were systematically synthesized. Evidence Review: Paired reviewers independently screened MEDLINE, Embase, PsycINFO, and CINAHL databases from inception until March 20, 2022, for studies of patients with AD or their caregivers, eliciting values and preferences about treatment, rated risk of bias, and extracted data. Thematic and inductive content analysis to qualitatively synthesize the findings was used. Patients, caregivers, and clinical experts provided triangulation. The GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research) informed rating of the quality of evidence. Findings: A total of 7780 studies were identified, of which 62 proved eligible (n = 19442; median age across studies [range], 15 years [3-44]; 59% female participants). High certainty evidence showed that patients and caregivers preferred to start with nonmedical treatments and to step up therapy with increasing AD severity. Moderate certainty evidence showed that adverse effects from treatment were a substantial concern. Low certainty evidence showed that patients and caregivers preferred odorless treatments that are not visible and have a minimal effect on daily life. Patients valued treatments capable of relieving itching and burning skin and preferred to apply topical corticosteroids sparingly. Patients valued a strong patient-clinician relationship. Some studies presented varied perspectives and 18 were at high risk for industry sponsorship bias. Conclusions and Relevance: In the first systematic review to address patient values and preferences in management of AD to our knowledge, 6 key themes that may inform optimal clinical care, practice guidelines, and future research have been identified..
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U2 - 10.1001/jamadermatol.2022.6045
DO - 10.1001/jamadermatol.2022.6045
M3 - Review article
C2 - 36696136
SN - 2168-6068
VL - 159
SP - 320
EP - 330
JO - JAMA Dermatology
JF - JAMA Dermatology
IS - 3
ER -