Impact of an eHealth Smartphone App on Quality of Life and Clinical Outcome of Patients With Hand and Foot Eczema: Prospective Randomized Controlled Intervention Study (Preprint)

Abstract

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