Methicillin-Resistant Staphylococcus aureus Eradication and Decolonization in Children Study (Part 2): Patient- and Parent-Centered Outcomes of Decolonization

Courtney M Moore, Sarah E Wiehe, Dustin O Lynch, Gina Em Claxton, Matthew P Landman, Aaron E Carroll, Paul I Musey, Courtney M Moore, Sarah E Wiehe, Dustin O Lynch, Gina Em Claxton, Matthew P Landman, Aaron E Carroll, Paul I Musey

Abstract

Background: Skin and soft tissue infections (SSTIs) due to community-acquired methicillin-resistant Staphylococcus aureus (MRSA) can lead to a number of significant known medical outcomes including hospitalization, surgical procedures such as incision and drainage (I&D), and the need for decolonization procedures to remove the bacteria from the skin and nose and prevent recurrent infection. Little research has been done to understand patient and caregiver-centered outcomes associated with the successful treatment of MRSA infection.

Objective: This study aimed to uncover MRSA decolonization outcomes that are important to patients and their parents in order to create a set of prototype measures for use in the MRSA Eradication and Decolonization in Children (MEDiC) study.

Methods: A 4-hour, human-centered design (HCD) workshop was held with 5 adolescents (aged 10-18 years) who had experienced an I&D procedure and 11 parents of children who had experienced an I&D procedure. The workshop explored the patient and family experience with skin infection to uncover patient-centered outcomes of MRSA treatment. The research team analyzed the 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.

Results: The workshop identified 9 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.

Conclusions: This study represents an innovative HCD approach to engaging patients and families with lived experience with MRSA SSTIs in the study design and trial development to determine meaningful patient-centered outcomes. We were able to identify 9 major recurrent themes. These themes were used to develop the primary and secondary outcome measures for MEDiC, a prospectively enrolling comparative effectiveness trial.

Trial registration: ClinicalTrials.gov NCT02127658; https://ichgcp.net/clinical-trials-registry/NCT02127658.

Keywords: Staphylococcus aureus; abscess; decolonization; human-centered design; patient-centered outcomes.

Conflict of interest statement

Conflicts of Interest: PM has received research funding from Trevena Inc, the Emergency Medicine Foundation, and Society of Academic Emergency Medicine Foundation.

©Courtney M Moore, Sarah E Wiehe, Dustin O Lynch, Gina EM Claxton, Matthew P Landman, Aaron E Carroll, Paul I Musey. Originally published in Journal of Participatory Medicine (http://jopm.jmir.org), 20.05.2020.

Figures

Figure 1
Figure 1
Patient advisor fill-in-the-blank discussing discomfort from methicillin-resistant Staphylococcus aureus.
Figure 2
Figure 2
Parent advisor collage.
Figure 3
Figure 3
Parent advisor fill-in-the-blank.

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