Eczema workshops reduce severity of childhood atopic eczema

Abstract

An intervention study was conducted to assess the effectiveness of a nurse-led eczema workshop in reducing the severity of atopic eczema in infants, children and adolescents. Ninety-nine new patients referred to the Dermatology Department of The Royal Children's Hospital in Melbourne, Australia, for the management of atopic eczema were randomized to receive care from an eczema workshop or a dermatologist-led clinic. Patients were followed-up 4 weeks after the intervention. The primary outcome was the severity of eczema as determined by scores obtained using the Scoring of Atopic Dermatitis (SCORAD) index at a 4-week follow-up visit. The secondary outcome was a comparison of treatments used in both clinics. At the 4-week review the mean improvement in SCORAD was significantly greater in those patients attending the eczema workshop than those attending the dermatologist-led clinic (-9.93, 95% confidence interval -14.57 to -5.29, P < 0.001). Significantly more patients from the eczema workshop improved from moderate severity eczema at baseline to mild at review. There was greater adherence to eczema management in the eczema workshop compared with the dermatologist-led clinic. In this study, patients attending the eczema workshop had a greater improvement in eczema severity thanpatients attending a dermatologist-led clinic, supporting collaborative models of service provision.

Scoping systematic review of treatments for eczema

“…The nurse-led workshops in the study by Moore and colleagues 356 were found to confer a statistically significant decrease in eczema severity compared with the dermatologist consultations, with a mean difference in SCORAD score between the treatment groups of -9.93 (95% Cl -14.57 to -5.29; p < 0.001). It is not reported whether the SCORAD assessors were blinded but it is unlikely that this was the case.…”

“…An Australian trial by Moore and colleagues 356 compared one 90-minute 'workshop' with a dermatology nurse consultant with an average 40-minute consultation with a dermatologist in 165 children with a new referral for eczema. The nurse-led workshop involved a history being taken and SCORAD scores being obtained, an examination, a management plan, a demonstration of techniques for applying treatments and prescriptions and equipment cards being obtained.…”

“…It is reassuring to note that both health-care professionals had a significant positive impact on the people with eczema that they treated. The positive results from a nurse-led clinic in Australia 356 should be interpreted with caution as there were many methodological issues, such as differences in the ways that the separate nurse and dermatologist clinics were run, that could lead to bias. Good-quality evidence of the particular benefits of nurse-led clinics and dermatologist-led clinics is needed to inform dermatology services as effectively and economically as possible in the future.…”

Online video improves clinical outcomes in adults with atopic dermatitis: A randomized controlled trial

“…5,15 For these reasons, AD education that addresses the pathophysiology of the disease, its management, and practical demonstrations has the potential to improve clinical outcomes. 11,16 However, the interventions previously cited in the literature may be timeconsuming and costly in clinical practice, thereby potentially limiting their widespread implementation. In this study, we created educational online videos and written pamphlets for patients with AD that are readily accessible and distributable.…”

Dry Skin in Childhood and the Misery of Eczema and Its Treatments

“…Studies on demonstration of treatments by a specialist nurse have shown the benefi t of this [93][94][95][96] . Carroll et al [ 59 ] suggested that the cost of treating eczema could be reduced by 'targeting parents and caregivers with education and psychosocial support' that might decrease family and personal burden'.…”