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040 Creating diverse approaches for shared decision- making (SDM) in atopic dermatitis treatment choices
  1. Li-Chin Chen1,
  2. Jeng-Wei Chiu2,
  3. Chia -Yu Chou1,
  4. Szu-Fen Huang3,
  5. Lu-Cheng Kuo4,
  6. Shey-Ying Chen1,5
  1. 1Center for Quality Management
  2. 2Department of Dermatology
  3. 3Department of Nursing
  4. 4Department of Technology
  5. 5Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan

Abstract

Introduction Atopic Dermatitis (AD) is a chronic skin condition influenced by genetics, immunological issues, and environmental factors. Choosing the right treatment is crucial. The Shared Decision-Making for AD aims to align treatment plans with patient expectations and enhance communication between healthcare providers and patients.

Methods We established a collaborative SDM team for the treatment of AD. The team includes attending physicians, resident physicians, nurses, pharmacists, quality management, and information engineers. Adopting the Ottawa Decision Support Framework, team members underwent educational training.

The SDM model is based on a structured information form, comprising two main elements: 1. PDA: Content includes evidence-based treatment options (such as phototherapy, immunomodulators, biologics, etc.). Patients make choices based on personal preferences using a 5-point scale, and the system automatically scores the preferences. Preference choice scores exceeding 24 indicate a preference for immunomodulators/biologics, while scores below 24 indicate a preference for phototherapy. 2. Outcome assessments include 1.SMM-9 options and 2.Preparation for Decision Making Scale.

Results PDA were developed in 2019, and by 2023, 53 patients utilized the system, with 39 completing the PDA and 37 completing the outcome assessment. Satisfaction scores were all above 81. The system is also utilized by five medical institutions.

Discussion To enhance utilization, a push notification feature was added to the system in 2021, providing QR codes for outpatient patients to read the SDM electronic forms multiple times. Simultaneously, an immediate intelligent dashboard system was established, seamlessly integrating the SDM.

Conclusion(s) The interdisciplinary team successfully implemented Shared Decision-Making (SDM) for atopic dermatitis patients, regularly updating it based on the latest evidence-based practices. Utilizing technology such as Redcap and a real-time dashboard improves communication between physicians and patients. Integrated process records assist in informed treatment decisions, maximizing the benefits of SDM.

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