Improving Patient Education With an Eczema Action Plan: A Randomized Controlled Trial

Abstract

A major challenge to atopic dermatitis (AD) management lies in its complex treatment, which must be tailored for both acute exacerbations and long-term maintenance. The addition of a written eczema action plan (EAP) to the routine verbal instruction (VI) may enhance patients' understanding of AD and facilitate treatment adherence. 1 This randomized controlled study was designed to evaluate the effect of a written EAP on patient and caregiver understanding of AD, distress level regarding treatment regimen, and preference for the addition of an EAP compared with those receiving traditional in-office VI. Methods. The study was approved by the New England Institutional Review Board (IRB No. 11-137; IORG registration No. IRB00000755), registered at ClinicalTrials .gov (NCT01660217), and conducted at a private dermatology office. The study schema flow diagram is shown in the Figure. Thirty-seven participants were randomized to receiving either VI or EAP (eAppendix 2; http: //www.jamaderm.com) at the end of a clinic visit. The EAPs were tailored to each patient given their age, location, and disease severity. After receiving either VI or EAP, the participants completed surveys (eAppendixes 3 and 4) on their self-perceived understanding, comfort, and anxiety level regarding AD management. The initial VI group then crossed over and received an EAP, and their outcomes were assessed again. The effect of the EAP on participants' perception of AD management was compared with that of VI. Their responses were recorded on a numeric scale of 0 to 10, with 10 indicating the most positive self-perception. The control group participants were asked whether they preferred VI alone, the EAP alone, or both, and to list reasons for their preference.

Systematic review of self‐management interventions for people with eczema

“…). After the exclusion of 10 papers, we included 23 articles that described 20 RCTs. Two studies were published in German and were translated for the purpose of this review.…”

“…Two studies were published in German and were translated for the purpose of this review. Two articles were published as research letters …”

“…The majority of studies were conducted in Europe ( n = 14) and the U.S.A. ( n = 4). Most ( n = 18) were set in secondary care with participants recruited via dermatology and paediatric outpatient clinics …”

“…In the majority of studies ( n = 16), the participants with eczema were children, but two studies were of adults with eczema, and two were of adults and children with eczema . One study included participants with eczema, psoriasis and other chronic skin diseases …”

The Effectiveness of Written Action Plans in Atopic Dermatitis

“…Shi et al performed a randomized controlled trial comparing an EAP ( n = 18) with verbal instruction ( n = 19). Patients and caregivers were surveyed on knowledge of AD self‐management immediately after receiving either intervention.…”