Innovating on innovation training with the Virtual Magic Wand (VMW) program: a qualitative study.

To identify and solve unmet needs and bring new therapies to patients, clinicians at all levels must engage in innovation. The Magic Wand Initiative, a program based at Massachusetts General Hospital-Wellman Center for Photomedicine, created a 10-months course called the Virtual Magic Wand (VMW) program that is a curriculum that teaches the biomedical innovation pathway to dermatologists and engages them in this creative process. This study aims to identify the impact of the VMW program on participants and consider the potential benefits of an innovation curriculum. The authors conducted semi-structured interviews in which alumni of the VMW program were asked about their experiences with innovation before, during, and after the program. Using grounded theory methodology, data were analyzed using deductive coding methods. The most cited benefit of the program was the opportunity to network (n = 12, 100%)-specifically, the mentorship opportunities (n = 10, 83%) and specialty-specific peer groups (n = 9, 75%). Other benefits included a change in mindset regarding their clinical work (n = 11, 92%) and learning the process of innovation (83%). Among barriers, lack of time (n = 7, 58%), knowledge (n = 6, 50%), and resources (n = 5, 42%), were the most mentioned. All alumni interviewed have stayed engaged in the field of biomedical innovation after their completion of the VMW program. These findings show that the VMW program positively impacted the lives and careers of participants. This study identified some of the systemic reasons that deter physicians from regularly engaging in innovation and provides guidance for how to design other innovation programs and further support the advancement of medicine.

Pharmionics in dermatology: a review of topical medication adherence.

The objective of this article was to review patient adherence to topical medications and its relationship to health outcomes in dermatologic disease. To this end, MEDLINE searches from January 1966 through June 2006 and EMBASE searches from January 1974 through June 2006 were conducted. Relevant human efficacy studies, including randomized controlled trials, observational studies, and case-control studies, were selected on the basis of the key words 'compliance,' 'adherence,' 'pharmionics,' 'topical,' 'medication,' or 'dermatology.' Studies were included and reviewed on the basis of their experimental design, controls, and statistical analysis. Analysis revealed that suboptimal adherence to topical medications is a common cause of minimal response or lack of response to drugs and is linked with poor dermatologic outcomes in diseases such as psoriasis, atopic dermatitis, and acne. It is concluded that non-adherence to topical medications is as common as non-adherence to oral medications, and its relationship to poor health outcomes is clear. Several barriers to topical medication adherence and predictors of non-adherence are similar to those for oral medications, while other barriers and predictors are unique to topical medications and the nature of dermatologic disease. Further studies of effective interventions to increase adherence are necessary to improve health outcomes in dermatology.