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

ObjectiveHealthcare 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.MethodsA 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.ResultsHCPs 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.ConclusionHCPs recognize the importance of discussing TCAM use for childhood eczema, and potential benefits for HCP–patient communication.Practice implicationsFuture tools to facilitate TCAM discussion should prioritise use of existing IT systems and address barriers to use, especially lack of time.