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Semin Cutan Med Surg. 2017 Sep;36(3):131-136. doi: 10.12788/j.sder.2017.029.

Atopic dermatitis: therapeutic care delivery: therapeutic education, shared decision-making, and access to care.

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1Allergy Program, Division of Immunology, Boston Children's Hospital, Boston, Massachusetts, USA.
Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California, USA.
Departments of Dermatology and Pediatrics, University of California, San Diego School of Medicine, La Jolla, California, USA.
Miami Itch Center Department of Dermatology and Cutaneous Surgery, Miller School of Medicine University of Miami, Florida, USA.


Atopic dermatitis (AD) is a chronic skin condition affecting children and adults, with a significant negative impact on patient and caregiver quality of life (QOL). Although effective treatments for AD are available, outcomes are often limited by poor adherence to treatment plans. Effective patient and caregiver education about the disease and its management is a necessary and important component of AD care. Therapeutic patient education (TPE) is a patient-centered process that aims to transfer information and skills necessary to manage and cope with a disease from health care professionals to patients and caregivers. Shared decision making between the health care provider and the patient/caregiver is an integral component of the TPE process and recognizes the importance of both the medical provider's clinical expertise, as well as the patient/caregiver's preferences and experiences regarding their own medical condition and its treatment. TPE programs for patients with AD and their caregivers are typically provided by multidisciplinary teams and utilize a number of different methods and tools to facilitate the transfer of knowledge and skills through both individual care and group-based educational sessions. TPE has been demonstrated to improve outcomes such as AD disease severity, treatment adherence, QOL, and coping with itch. It is important to consider strategies to reduce barriers to cost-effective accessible AD education and treatment.



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