Nurse Involvement Crucial to Therapeutic Patient Education in Patients with AD

Hélène Aubert, PhD

A new global investigation into the role of nurses in atopic dermatitis management suggested that the dynamic between physicians and nurses was crucial in the improvement of therapeutic patient education (TPE).

Therapeutic patient education has been applied in the management of several chronic diseases and is intended to support self-management among patients with AD as well as promote therapeutic adherence.

Notably, guideline recommendations suggested TPE as a basic therapy for all AD patients regardless of age or disease severity, and recent data has shown that such programs result in positive effects on disease severity, management, and quality of life.

However, TPE is often hard to implement without the aid of nurse-led consultations.

For this study, an investigative team led by Hélène Aubert, PhD, of Nantes University Hospital in France, detailed a global survey conducted by the International Task Force for AD (ISAD-OPENED Task Force) to determine the current role of nurses in TPE for patients with AD.

From July to December 2019, a cross-sectional study was conducted via questionnaire by a myriad of health professionals.

The questionnaire was developed in the English language on Survey Monkey and featured 24 items before being emailed to all members of the ISAD OPENED network. This network featured 62 global experts from 23 countris in the field of TPE in AD.

Members of the network were encouraged to share the survey with colleagues including physicians, nurses, and psychologists.

In total, 85 health care professionals from 20 countries responded to the questionnaire; specifically, responses from 28 nurses, 56 dermatologists, and 1 psychologist were included in the questionnaire.

Among them, nearly 75% of responding physicians and nurses cited interprofessional coworking while caring for patients with AD, while 20% worked autonomously (17).

Regarding TPE training, 57 (67%) participants had training specific to TPE while 57 (67%) had learning based on personal experience. Thirty-three participants declared both.

Notably, 51% of respondents deemed the collaboration between nurses and physicians to be “excellent”, followed by 36% considering it to be “good” and 3% deeming it “poor”.

Meanwhile, joint consultations for patients with AD were reported by 76.5% of participants, while 55.3% of respondents declared active participation in TPE sessions with patients with AD.

When considering follow-up, telephone or e-mail follow-ups were conducted by 31.7% of respondents – 13 nurses, 12 physicians, and 2 assistants- and answering patient questions was done by phone or email by 64.7% of respondents. A total of 67% respondents reported practicing an educational approach for the treatment of other pathologies.

Regarding financial compensation, additional payment for TPE was given to 34.1% of respondents, while 62.3% were not paid for their work. Over half (55%) of nurses provided consultations without physician assistance.

The survey found that the main preventative actions for nurse involvement in TPE were insufficient training (44.7%), lack of recognition and remuneration (40%), lack of nurses (67%), lack of funding (51.7%) and lack of motivation (22.7%).

“Nurses offer their time, skills, and knowledge in communicating with patients and their families,” the team wrote. “Among the areas for improvement in this field, we propose the recognition of the role of nurses in the care of AD patients, because they can replace the doctor in certain tasks, which leads to reducing the costs of the intervention.”

The study, "The role of nurses in the management of atopic dermatitis: Results of an international survey," was published online in JEADV Clinical Practice.