Improving Outcomes in Adults with Atopic Dermatitis: Building a Foundation

This is the second of a four-part series on improving patient adherence in management of atopic dermatitis.

figure 1 pyramid

A strong doctor-patient relationship is an essential component of the foundation that supports adherence (Figure 1). A key element that is critical to this relationship is for the patient to judge the provider to be caring and friendly.1 Every part of our clinical encounter can be used to communicate that we care, starting even before patients walk into our office with how our staff answers their phone call. Other factors that occur before the patient sees us are important as well. Is our waiting room clean, organized, and inviting? Visual cues such as a closed off front desk, dim lighting, and outdated reading materials can convey a perceived lack of care.

In addition, small changes in provider routine can impact patients’ perceptions. Entering the room slowly, establishing eye contact and greeting everyone present in the room, mentioning you are washing your hands to protect them, actively listening, and incorporating touch into our clinical exam can all contribute to success.
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RELATED CONTENT

Improving Outcomes: Part I – Impact of Nonadherence
Treating Head and Neck Atopic Dermatitis
Tools of the Trade: Managing Atopic Dermatitis Itch in Adults
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Beyond trust and sense of caring, accountability is unappreciated as a factor contributing to adherence as exemplified by the parable of the 2 piano teachers. A piano teacher arranged weekly lessons for her students in preparation of their recital in 12 weeks. The night of their performance was a huge success. After the recital, another teacher saw the success and believed that it was the students’ regular practice at home, not the weekly lessons, that prepared them for the performance. He told his students that he would provide them with music to practice daily at home for their recital in 12 weeks, but that they would not need weekly lessons. The recital was miserable, as without the weekly lessons, the students did not practice every week.

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