title: The challenges of facilitating primary healthcare discussions on traditional, complementary and alternative medicine for childhood eczema: piloting a computerized template.
abstract: 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.
  
  
  CONCLUSIONS
  HCPs recognize the importance of discussing TCAM use for childhood eczema, and potential benefits for HCP-patient communication.
  
  
  CONCLUSIONS
  Future tools to facilitate TCAM discussion should prioritise use of existing IT systems and address barriers to use, especially lack of time.
authors.affiliation: London South Bank University, London, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Robinson
authors.forename: Ava
authors.initials: A
authors.lastname: Lorenc
authors.forename: Andrew
authors.initials: A
authors.lastname: Falinski
authors.forename: Ricky
authors.initials: R
authors.lastname: Banarsee
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003142:Communication; D000529:Complementary Therapies / Q000458:organization & administration* / Q000706:statistics & numerical data; D003201:Computers; D004485:Eczema / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008131:London; D008297:Male; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D012017:Referral and Consultation / Q000706:statistics & numerical data