Summary
Topical therapies are very important to treat skin diseases, yet many patients fail to use them properly. Adherence to topical treatment regimens is estimated to be 50-70% in patients with psoriasis and non-adherence is associated with worse treatment outcomes and quality of life. St John’s Institute of Dermatology created an online resource, consisting of six educational videos, to empower patients to use topical treatments safely and effectively. A systematic framework was instigated to develop the resource, which has been published in the British Journal of Dermatology. Clinical need was assessed by systematic searches of Google and YouTube. This identified a lack of impartial and evidence-based patient education videos. A total of 116 patients were consulted regarding video content and style. A multidisciplinary team of clinicians, specialist nurses, pharmacists and communications officers then developed video scripts. Video content was evidence-based, according to National Institute of Health and Care Excellence (NICE) guidelines. The video resource was then evaluated by 34 patients and 99 healthcare professionals. It has attracted over two million views on YouTube. Analysis of these data will help direct the development of future patient education resources.
Method
Video scripts were developed by incorporating content based on current NICE guidelines and were drafted by a team of dermatologists, specialist nurses, pharmacists and members of the Guy’s and St Thomas’ NHS Foundation Trust (GSTT) communications team. Internal peer review of the scripts was then carried out by 15 dermatology consultants. Production of the videos was funded by the British Association of Dermatologists (BAD). They were filmed at Guy’s Hospital in the presence of a consultant dermatologist and were uploaded onto the GSTT, St John’s Dermacademy and BAD websites, as well as to YouTube. The videos were accompanied by a downloadable patient information leaflet that elaborated on the key points demonstrated in the video. The SurveyMonkey tool was used to disseminate online questionnaires to patients attending St John’s Institute of Dermatology and to clinicians affiliated with the St John’s Dermatological Society.
Results
The effectiveness of this resource is demonstrated by user feedback. All patients trusted the video content and the majority said they would change how they managed their skin conditions and that they would recommend the video to other patients. When 99 HCP were asked to review the videos, the majority thought they were a useful platform for patient education and that they would change the way they practice. The effectiveness of this resource is also demonstrated by its popularity on YouTube, attracting over 2 million views since its launch. The three most viewed videos were about emollients, topical steroids and scalp psoriasis. Analysis of these data demonstrates that most video viewers were under the age of 34 and viewed the videos using a mobile telephone. The majority were not from the UK, which demonstrates the global reach of this resource.
Sustainability and Spread
Long-term hosting of the videos has been pledged by GSTT and the BAD. This means that further funding is not needed in order to keep this resource in the public domain. Furthermore, both bodies are committed to further develop and integrate the resource. Numbers of views have continued to increase. It is being made more accessible to patients via QR codes on clinic documentation and links have been forged with St John’s Dermacademy, which has pledged financial support for further expansion. The addition of subtitles will make these videos more accessible to an internal audience, as well as patients with speech and language difficulties. Given its wide relevance, and increasing uptake, this is a highly sustainable resource. The hope is that the systematic framework used to develop it may serve as a model for other future healthcare patient education video initiatives. To this end, it has been published in the British Journal of Dermatology. A manuscript incorporating analysis of the YouTube resource is also being drafted, as this has important implications for the development of future videos. The videos have been used by Cambridge University Hospitals NHS Trust, NHS Tayside and Great Ormond Street Hospital. A link to them has also been added to the Dermnet NZ website, which attracts over 2 million users per month.
