Currently submitted to: Journal of Participatory Medicine
Date Submitted: Jun 7, 2019
Open Peer Review Period: Jun 10, 2019 - Aug 5, 2019
(currently open for review)
Outcomes of Importance for MRSA Decolonization Identified by Patient and Parent Advisors: A Qualitative Study
Skin and soft tissue infections (SSTI) due to community acquired Methicillin-Resistant Staphylococcus aureus (MRSA) can lead to a number of significant outcomes including hospitalization and/or surgical procedures like incision and drainage. Unfortunately, these infections can present in children and adolescents without any other medical problems. Procedures to decolonize or remove the bacteria from the skin and nose of these patients are sometimes recommended in order to prevent the large rate of infections that reoccur.
The objective of this component of the MRSA Eradication and Decolonization in Children (MEDiC) study was to uncover outcomes of importance to patients and their parents when it comes to MRSA decolonization.
A four-hour human-centered design (HCD) workshop was held with five adolescents (from age 10 to 18) who had experienced an incision and drainage procedure and eleven parents of children who had experienced an incision and drainage procedure. The workshop explored the patient and family experience with skin infection to uncover patient-centered outcomes of MRSA treatment. The team analyzed audio and artifacts created during the workshop and coded for thematic similarity. The final themes represent patient-centered outcome domains to be measured in the MEDIC comparative effectiveness trial.
The workshop identified nine outcomes of importance to patients and their parents – fewer MRSA outbreaks, improved emotional health, improved self-perception, decreased social stigma, increased amount of free time, increased control over free time, fewer days of school or work missed, decreased physical pain and discomfort, and decreased financial burden.
This study represents an innovative HCD approach to engaging patients and families with lived experience with MRSA SSTI in study design and trial development to determine meaningful patient-centered outcomes. Through this crucial participation, we were able to identify nine major recurrent themes. These themes were used to develop the primary and secondary outcome measures for MEDIC, a prospectively enrolling comparative effectiveness trial. Clinical Trial: NCT02127658
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