Table 1 Guide for the patient-supporting consultations. The examples of questions or sentences will be modified by the nurse according to the patient’s needs at the time of the consultation
Theme | Examples of actions, questions, or sentences that the dermatology nurses will use during the consultation |
1. Reminder system | |
Recommending a reminder system | “I really like reminder systems. Most people find a reminder system useful. Are you using one?” If so, “Tell me about your own reminder system.” If not, “what kind of reminders might work well for you?” |
2. Accountability | |
Ask patients to call two days after they have filled their prescription | “Here’s my personal number. Please call me in two days and leave a message telling me what you like and dislike about the treatment” |
Ask patients to keep a diary | “I recommend you keep a diary, where you write down any questions and good experiences you have during the treatment.” “I’m looking forward to our next visit/call, to find out how well the medicine is working and to get a sense from you if you've been able to use it regularly. I have a small gift for those of my patients who are able to stick with the treatment plan.” |
3. Reinforcement | |
Giving positive feedback at every follow-up visit | “Your skin looks very good; I can really see that you’re putting a great effort into applying the topical preparations” “I’m impressed to see how well you are in control of handling any flare-ups” |
Rewarding patients that fulfill their treatment plans | Give the patient a gift when the patient is half-through the treatment period. The patient will receive some chocolate, for example, with a card specially written for them. |
4. Building trust | |
4.1 Increasing the perceived efficacy of the treatment | |
Telling the patient that the prescribed treatment is a good and popular treatment | “I had a patient whose psoriasis was very similar to yours and who did very well on this treatment. Patients really like this treatment” |
4.2 Placebo-tailoring (part of building trust in the treatment) | |
List many different treatment options, but always recommend one treatment | Have a list of many different treatment options, but always circle the one prescribed for the patient |
4.3 Building trust in the healthcare provider | |
Optimize the patients' contact with the health care professionals | Hand the patient your personal card. The dermatology nurses write down their telephone number and inform the patient that the number is exclusively for them to use. While writing on the card the dermatology nurse tells the patient: “Here’s my personal telephone number. During the treatment phase if you have any questions about the treatment, please call me and leave a message and I’ll get back to you.” |
5. Increase ease of use via favorable comparison with other treatment options | |
Tell patients about other treatments that have more severe side-effects than the one prescribed | “If you do not use this topical treatment, it might be necessary to prescribe chemotherapy, which has more severe side-effects” |
Tell patients that their skin can be treated with a moisturizer once a day, while other patients may need to use many different moisturizers at least four times a day | Tell the patient to use a moisturizer four times a day and then say: “Wait, once a day would be enough for you” |
Explain that the treatment regimen is simple | Make the treatment seem simple by saying: “some use this treatment lots of times a day, but now you have learned how to apply the treatment, you can use it once a day” |
Make the treatment seem less messy | Tell the patient about the side-effects and messiness using tar and ask the patient if they want to smell a can of tar (have a sample in the consultation room and leave a tar stain on the sink). |