Tethered education: Aligning patients and providers 

What spurs patients to choose one treatment option over another? What are the hurdles patients face when presented with a newly FDA approved drug? What barriers to change keep physicians from prescribing new treatments? 

The practice of shared decision making can help answer these crucial questions. This approach can increase therapy adoption, patients’ adherence to their management regimen and align treatment expectations between health care providers and patients. As shown by outcome data from aligned patients and clinicians education programs recently delivered by PlatformQ Health, tethered education has become an integral part of this process. Tethered education programs educate and interact directly with patients and providers around a single medical condition, empowering patients to take an active role in care. The benefits are two-fold: 

• These programs have proven effective for educating patients and providers about current, new, and emerging management options. 
• Often these programs uncover and address knowledge gaps that may impede improved patient outcomes, and shed light on crucial dialogue that should occur between providers and patients. 

Closing educational gaps in atopic dermatitis 

Recent multi-year programming on atopic dermatitis was able to highlight these impacts. Based on a review of the medical literature, interviews, and published surveys, PlatformQ Health discovered gaps in knowledge, competence, and behaviors about the condition and its management among patients and providers. The data revealed that healthcare providers underrecognized the burden of atopic dermatitis and its effects on the quality of life of patients and their families, and especially its impacts on the patient’s ability to sleep. This may contribute to the reported undertreatment of atopic dermatitis among patients with moderate to severe disease. 

Meanwhile, patients needed a better understanding of how to articulate the burden of disease and discuss treatment choices. Patients were also eager to learn more about non-drug related approaches to their disease. Treatment regimens for moderate-to-severe atopic dermatitis can be complex, and patients’ adherence is often poor.

A patient-centric outcomes approach

To improve the time from diagnosis to effective treatment and improve patients’ quality of life, PlatformQ Health and the Asthma and Allergy Foundation of America launched a tethered education program on PlatformQ Health’s online education channels, ImmunologyLive and MedLive. 

Launched in November of 2018, the program featured an expert panel of healthcare providers, a representative from the Asthma and Allergy Foundation of America, and a patient living with eczema. The activities included live Q&A opportunities, as well as live polling to gauge caregiver and patient concerns, management behavior, and patients’ feelings about living with eczema. The patient education was then broken into 20-minute chapters, and remained on-demand at MedLive.com and on Facebook video. 

Two months after the program, surveys found 93% of providers and 79% of caregivers/patients had improved knowledge of the subject. Awareness of newly available targeted treatment options was also high among participating patients, who reported a high level of understanding of strategies to help their symptoms. 

Key areas in need of improvement were also identified with surveys conducted prior to, during, and after the sessions. Notably, post-session surveys revealed that patients and caregivers may tend to overuse steroids to control their condition. In addition, there continued to be a disconnect between patients’ desire to incorporate more non-drug related management strategies, and the clinicians’ likelihood to prescribe immunosuppressants.  

Powering future educational initiatives 

Based on its findings, PlatformQ Health’s team provided recommended actions, including:

• Building upon acquired knowledge by enhancing communication between patients and providers
• Continuing to clarify to clinicians that optimal management of atopic dermatitis requires a combination of behavioral and drug therapy
• Enhancing clinicians’ awareness of safety and monitoring requirements of targeted treatment to break down barriers to adoption 

Building on this foundation, a second year of tethered educational programming launched in 2020 with a two-session summit for providers, including patient cases and a separate aligned patient program. 

• The provider session “Strategies for Communicating and Prioritizing Treatment Goals” provided a deep dive into the assessment of quality of life to adjust treatment to achieve patients’ preferred goals.
• The provider session “Atopic Dermatitis: A Clear Roadmap to Treatment Success” was a case-based program to build competence related to incorporation of targeted  treatment options to overcome the limitations of traditional topical and systemic treatment for quality of life improvements.
• The patient session “Taking Charge of my Eczema” offered strategies and resources to help patients and caregivers communicate and prioritize treatment goals with clinicians, and practice shared decision-making with clinicians regarding management decisions.

The clinicians’ programs included a patient’s voice component, with patients’ interviews interspersed through the content. Bringing the patient voice into the clinicians’ educational sessions opened providers’ eyes to the real struggles and expectations of patients. Since one of the barriers identified was that of clinicians underestimation of the negative impacts of itch on sleep quality, one of the interviews was a 17-year-old patient, who reported serious sleep deprivation due to constant itching.

To date, 1,194 healthcare provider learners and 17,613 patients and caregivers participated in the latter program. 

The second year program was able to address the mismatch between patients’ and clinicians’ expectations for treatment. Specifically, after the program, 30% of provider learners showed an increase in competence related to matching treatment decisions to patients’ goals. 

Tethered education provides an environment where patients and providers can share general concerns, and compare and contrast preconceptions vs. real-world attitudes. These activities not only educate patients and providers about multitargeted management options, they help all relevant stakeholders better identify the unique needs and wants of patient populations. Ultimately, identifying and addressing patients’ expectations through shared decision making can improve outcomes that matter most to patients. This approach helps inform future decisions for all stakeholders involved in the enhancement of healthcare quality and overall patient outcomes.  

For more information, explore our educational program outcomes.