Children’s Views and Experiences of Treatment Adherence and Parent/Child Co-Management in Eczema: A Qualitative Study

Abstract

Eczema affects one in five children and can have a substantial impact on quality of life. This qualitative study aimed to explore children’s views and experiences of eczema and what may affect treatment adherence from their perspective. We conducted semi-structured, face-to-face interviews with children with eczema aged 6–12 years from March to July 2018. Interviews were transcribed verbatim and analysed using inductive thematic analysis. We found that children do not typically view eczema as a long-term condition, and topical treatments (predominately emollients) were seen to provide effective symptom relief. Uncertainty around co-managing at home was expressed as children typically felt that parental reminders and assistance with applying different types of topical treatments were still needed. For some children, eczema can be difficult to manage at school due to a lack of convenient access and appropriate spaces to apply creams and psychosocial consequences such as attracting unwanted attention from peers and feeling self-conscious. Treatment adherence could be supported by reinforcing that eczema is a long-term episodic condition, providing clear information about regular emollient use, practical advice such as setting reminders to support co-management at home, and working with schools to facilitate topical treatment use when necessary.

Effectiveness and safety of lotion, cream, gel, and ointment emollients for childhood eczema: a pragmatic, randomised, phase 4, superiority trial

“…26 These findings are consistent with previous qualitative research, which identifies trade-offs between effectiveness and acceptability when choosing an emollient. 27,28 In short, a one size fits all approach is not appropriate and users need to be able to choose from a range of emollient types to suit their needs and preferences. Interpretation of our findings will be strengthened by a planned formal health economic analysis.…”

General practitioners' explanation and advice on childhood eczema and factors influencing their treatment strategy: A qualitative study

“…found treatment adherence could be supported by stressing that AD is a long‐term episodic condition. 21 The perception that AD is not considered as a long‐term condition by parents of children with AD is also highlighted by the review of qualitative studies of Teasdale et al. This had implications for the perceived necessity of long‐term treatment.…”

How has the COVID‐19 pandemic affected eczema self‐management and help seeking? A qualitative interview study with young people and parents/carers of children with eczema

“…The reported improvements to routine and increased use of treatments due to the removal of barriers to eczema self‐management during periods of staying at home highlight the hidden burden of self‐managing eczema and the importance of environmental factors. 17 , 18 , 19 There is a need for high quality consistent information and advice about eczema. 18 , 20 , 21 Eczema has a considerable psychosocial impact, 18 , 22 particularly amongst young people, 23 and families of children with eczema often need to rely on others for support with eczema care.…”

“…Previous research has identified barriers to self‐management, including limited knowledge of eczema, concerns about eczema treatments and treatments being time‐consuming. 3 , 4 , 5 , 6 …”