The challenges of facilitating primary healthcare discussions on traditional, complementary and alternative medicine for childhood eczema: piloting a computerized template

Patient Educ Couns. 2012 Dec;89(3):517-24. doi: 10.1016/j.pec.2012.03.007. Epub 2012 Mar 31.


Objective: Healthcare practitioners (HCPs) experience barriers to changing routine consultation practice. Communication and recording of traditional, complementary and alternative medicines (TCAM) is inadequate. This pilot study explored the challenges of implementing a computerized template in primary care to facilitate communication on TCAM for paediatric eczema.

Methods: A computerized template to record TCAM use, with links to evidence-based TCAM databases, was designed, based on qualitative research with patients and HCPs. Four London general practices implemented the template integrated with usual practice. Twelve focus groups during the 6 month study period explored HCPs' knowledge, communication and information sources regarding TCAM and perceived barriers to template implementation.

Results: HCPs were initially enthusiastic about discussing TCAM, for improving communication and understanding patient's choices, but the template was used in under a third of consultations. HCPs were surprised at low TCAM use (10%) and lack of correlation with eczema or ethnicity. Reported barriers were time and remembering, due to busy, target-driven practice.

Conclusion: HCPs recognize the importance of discussing TCAM use for childhood eczema, and potential benefits for HCP-patient communication.

Practice implications: Future tools to facilitate TCAM discussion should prioritise use of existing IT systems and address barriers to use, especially lack of time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Communication*
  • Complementary Therapies / organization & administration*
  • Complementary Therapies / statistics & numerical data
  • Computers*
  • Eczema / therapy*
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Infant
  • Interviews as Topic
  • London
  • Male
  • Physician-Patient Relations*
  • Pilot Projects
  • Primary Health Care / organization & administration*
  • Qualitative Research
  • Referral and Consultation / statistics & numerical data