Background Chronic hand and foot eczema is a polyetiological dermatological condition. Patients experience pain, itching, and sleep disturbances and have a reduced quality of life. Skin care programs and patient education can improve the clinical outcome. eHealth devices offer a new opportunity to better inform and monitor patients. Objective This study aimed to systematically analyze the effect of a monitoring smartphone app combined with patient education on the quality of life and clinical outcome of patients with hand and foot eczema. Methods Patients in the intervention group received an educational program; attended study visits on weeks 0, 12, and 24; and had access to the study app. Patients in the control group attended the study visits only. The primary end point was a statistically significant reduction in Dermatology Life Quality Index, pruritus, and pain at weeks 12 and 24. The secondary end point was a statistically significant reduction in the modified Hand Eczema Severity Index (HECSI) score at weeks 12 and 24. This is an interim analysis at week 24 of the 60-week randomized controlled study. Results In total, 87 patients were included in the study and randomized to the intervention group (n=43, 49%) or control group (n=44, 51%). Of the 87 patients, 59 (68%) completed the study visit at week 24. There were no significant differences between the intervention and control groups regarding quality of life, pain, itch, activity, and clinical outcome at weeks 12 and 24. Subgroup analysis revealed that, compared with the control group, the intervention group with an app use frequency of fewer than once every 5 weeks had a significant improvement in the Dermatology Life Quality Index at weeks 12 (P=.001) and 24 (P=.05), in pain measured on a numeric rating scale at weeks 12 (P=.02) and 24 (P=.02), and in the HECSI score at week 12 (P=.02). In addition, the HECSI scores assessed on the basis of pictures taken by the patients of their hands and feet correlated strongly with the HECSI scores recorded by physicians during regular personal visits (r=0.898; P=.002) even when the quality of the images was not that good. Conclusions An educational program combined with a monitoring app that connects patients with their treating dermatologists can improve quality of life if the app is not used too frequently. In addition, telemedical care can at least partially replace personal care in patients with hand and foot eczema because the analysis of the pictures taken by the patients correlates strongly with that of the in vivo images. A monitoring app such as the one presented in this study has the potential to improve patient care and should be implemented in daily practice. Trial Registration Deutsches Register Klinischer Studien DRKS00020963; https://drks.de/search/de/trial/DRKS00020963
BACKGROUND Chronic hand and foot eczema is a polyetiological dermatological condition. Patients suffer from pain, itching and sleep disturbances and have a reduced quality of life. Skin care programs and patient education can improve the clinical outcome. EHealth devices are a new opportunity to better inform and monitor patients. OBJECTIVE To systematically analyze the effect of a monitoring smartphone application combined with patient education on the quality of life and the clinical outcome of hand- and foot eczema patients. METHODS Patients in the intervention group received an educational program, attended visits on weeks 0, 12, 24, and had access to the study app. Patients in the control group attended the visits only. The primary endpoint was a significant reduction in Dermatology-Life-Quality-Index-score (DLQI), pruritus and pain at weeks 12 and 24. Secondary endpoint was a significant reduction of the modified Hand Eczema Severity Index (HECSI) at weeks 12 and 24. RESULTS Eighty-seven patients were included in the study and randomized into the intervention (43/87) or control group (44/87). There were no significant differences between the intervention and control groups concerning quality of life, pain, itch, activity and clinical outcome at weeks 12 and 24. Subgroup analysis revealed that the intervention group with an app usage frequency of less than once every five weeks had a significant improvement in the DLQI at weeks 12 (P=.001) and 24 (P=.05), in the pain-numeric rating scale (NRS) at weeks 12 (P=.02) and 24 (P=.02), as well as in the HECSI at week 12 (P=.02) as compared to the control group. CONCLUSIONS An educational program combined with a monitoring app that connects patients with their treating dermatologist can improve quality of life and the clinical outcome of patients with hand and/or foot eczema if the app is not used too frequently. CLINICALTRIAL Deutsches Register klinische Studien (DRKS): DRKS00020963
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