Experiences of carers managing childhood eczema and their views on its treatment: a qualitative study

Background: Childhood eczema causes significant impact on quality of life for some families, yet non-concordance with treatment is common. Aim: To explore parents' and carers' views of childhood eczema and its treatment. Design and setting: Qualitative interview study in primary care in the south of England. Method: Carers of children aged =5 years with a recorded diagnosis of eczema, who reported that eczema was still a problem, were invited to participate. Thirty-one parents were interviewed from 28 families. Results: Many parents expressed frustration with both medical care and prescribed treatments. They felt their child's suffering was not 'taken seriously', and experienced messages about a 'trial and error' prescribing approach and assurance that their child would 'grow out of it' as a further 'fobbing off', or dismissal. Many carers were ambivalent about eczema treatments, mainly topical corticosteroids but also emollients. Dietary exclusions as a potential cure were of interest to most families, although they perceived healthcare professionals as uninterested in this. Families varied in the extent to which they felt able to manage eczema and the length of time taken to gain control. In some instances, this was linked to not understanding advice or receiving conflicting advice from different healthcare providers. Conclusion: Poor concordance with treatments seems unsurprising in the presence of such dissonance between carers' and healthcare providers' agendas. Acknowledging the impact of the condition, greater attention to how key messages are delivered and addressing carers' treatment beliefs are likely to improve engagement with effective self-care.