Resident tips on effective communication with patients, plus ruxolitinib for vitiligo and hydroxychloroquine for oral lichen planus

Three dermatology residents — Dr. Elisabeth Tracey, Dr. Julie Croley, and Dr. Daniel Mazori — discuss tips for clear communication with patients in this special resident takeover of the podcast. Beginning at 6:11, they talk about challenges with topical therapies and setting expectations with patients. "We, as dermatologists, can optimize patient management by being effective communicators," said Dr. Croley. They provide communication strategies for improving compliance with therapy and ensuring patients have the correct instructions, as well as clarifying patient misconceptions and the importance of maintenance treatment. We also bring you the latest in dermatology news and research: 1. Topical ruxolitinib looks good for facial vitiligo in phase 2 study. About half of patients on the two highest doses had a 50% improvement after 6 months of treatment. 2. Patients concerned about clinician burnout. Almost three-quarters of Americans are concerned about burnout among health care professionals. 3. Antimalarial may be effective, safe for erosive oral lichen planus. Hydroxychloroquine sulfate may be an effective and relatively safe treatment option for moderate to severe oral lichen planus. Things you will learn in this episode: Review expectations of therapy with patients, such as an intense inflammatory response to topical 5-fluorouracil for actinic keratosis, to ensure that patients remain compliant with the therapy but also feel they can trust you as their physician. If patients are hesitant to use topical minoxidil because they are concerned with the length of time they'll have to use it, use a metaphor for another lifelong commitment such as brushing your teeth. "What I started actually doing is calling topical minoxidil toothpaste for your hair," said Dr. Mazori. Talk to patients about spot-treating with acne or applying topical medication appropriately for psoriasis. "A particular challenge in dermatology with topical medications is not just whether or not they use it or pick up the prescription but how they use it," said Dr. Tracey. Talk to patients about underapplication of sunscreen. Recommend a physical blocker if patients express concerns about systemic absorption. Write down instructions to ensure patients have the relevant information. The teach-back method of communicating with patients often is taught in medical school and ensures that the patients have understood what you've said, but it doesn't ensure that they retained it. Strategies such as having medical students write the instructions or copying notes from your electronic medical record to print for patients can help save time. Emphasize the importance of maintenance treatment for conditions such as intertrigo, seborrheic dermatitis, or onychomycosis to prevent recurrence. Give patients both the trade name and generic name to ensure they use the correct medication. Hosts: Elizabeth Mechcatie, Terry Rudd Guests: Elisabeth (Libby) Tracey, MD (Cleveland Clinic Foundation); Julie Ann Amthor Croley, MD (University of Texas Medical Branch at Galveston); and Daniel R. Mazori, MD (State University of New York, Brooklyn). Show notes by Melissa Sears, Alicia Sonners, and Elizabeth Mechcatie.   You can find more of our podcasts at http://www.mdedge.com/podcasts.    Email the show: [email protected] Interact with us on Twitter: @MDedgeDerm

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