How parents and children evaluate emollients for childhood eczema: a qualitative study

Abstract

BackgroundEczema affects one in five children in the UK. Regular application of emollients is routinely recommended for children with eczema. There are four main emollient types, but no clear evidence of which is best. The current ‘trial and error’ approach to find suitable emollients can be frustrating for parents, children, and clinicians.AimTo identify how parents and children experience and evaluate emollients.Design and settingQualitative interview study, nested within a primary care trial of emollients (Best Emollients for Eczema [BEE] trial).MethodSemi-structured interviews with children with eczema and their parents were conducted. Participants were purposively sampled on emollient type (lotion, cream, gel, or ointment), age, and eczema severity.ResultsForty-four parents were interviewed, with children participating in 24 of those interviews. There was no clear preference for any one emollient type. The strongest theme was the variation of experience in each of the four types. Participants focused on thickness and absorbency, both positively and negatively, to frame their evaluations. Effectiveness and acceptability were both considered when evaluating an emollient but effectiveness was the primary driver for continued use. For some, participating in the trial had changed their knowledge and behaviour of emollients, resulting in use that was more regular and for a longer duration.ConclusionThere is no one emollient that is suitable for everyone, and parents/children prioritise different aspects of emollients. Future research could evaluate decision aids and/or tester pots of different types, which could enable clinicians and parents/children to work collaboratively to identify the best emollient for them.

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

“…25 The findings from a nested qualitative study emphasised how the acceptability of the same product varies between users. 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.…”

Publication Trends of Qualitative Research in Dermatology

“…Figure 1 shows the PRISMA flow diagram of the selection criteria. A total of 1398 studies were screened, and 249 studies (17.8%) were ultimately included in the database …”

Effectiveness of calamine lotion as an adjunctive therapy to mometasone furoate ointment in the treatment of infant eczema: A retrospective study

“…[12][13][14] If such condition can not be treated fairly well, they may result in food allergies, wheezing, asthma, allergic rhinitis, and psychological and behavioral disorders. [10,[15][16][17][18][19] Mometasone furoate ointment (MFO) is a hormone that is absorbed little or can be quickly catabolized into an inactive degradation product after being absorbed in the skin. However, it retains a high degree of activity in the local areas.…”

“…[12–14] If such condition can not be treated fairly well, they may result in food allergies, wheezing, asthma, allergic rhinitis, and psychological and behavioral disorders. [10,15–19]…”