Interventions for preventing occupational irritant hand dermatitis

Bauer, Andrea; Schmitt, Jochen; Bennett, Cathy; Coenraads, Pieter‐Jan; Elsner, Peter; English, John; Williams, Hywel C

doi:10.1002/14651858.cd004414.pub2

Cited by 36 publications

(18 citation statements)

References 69 publications

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“…Hand eczema is often caused or aggravated by occupational exposures such as wet work, food handling, cutting oils etc. In several studies, interventions aiming at secondary prevention of occupational irritant hand eczema have been examined [16]. Comparisons have been made regarding the usage of protective equipment versus the usage of skin care products [17].…”

Section: Introductionmentioning

confidence: 99%

“…Both skin protection behaviour and objectively assessed symptoms were beneficially impacted in a group of health care personnel [18,19] and among employees in the food care industry [20,21]. However in general, interventional prevention trials have had methodological weaknesses and insufficient dimensions in terms of power [16,18] and only few studies have investigated skin protection programmes as a tertiary preventive measure. In Germany, a combined health educational and health psychological intervention i.e.…”

Section: Introductionmentioning

confidence: 99%

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Chronic hand eczema - self-management and prognosis: a study protocol for a randomised clinical trial

Mollerup

Veien²,

Johansen

2012

BMC Dermatol

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BackgroundHand eczema has a one-year prevalence of approximately 10 % in the general Danish population. Often the disease becomes chronic with numerous implications for the individual’s daily life, occupation and quality of life. However, no guidelines of self-management recommendations beyond the acute stage are given. Self-management of the disease is pivotal and involves self-monitoring of the condition, medication adherence, and preventive behaviour. Interventions best to support the individual in this ongoing process need to be developed.Methods/designThis paper describes the design of a randomised clinical trial to test a newly developed intervention of individual counselling versus conventional information. 300 patients consecutively referred to dermatologic treatment at two different settings are individually randomised to either the intervention programme, named ‘The Healthy Skin Clinic’ or to the control group. Block-wise randomisation according to setting and gender is carried out.The intervention offers a tool for self-monitoring; basic and specific individual counselling; the possibility of asynchronous communication with the intervention team; and an electronic patient dialogue forum. Primary outcome variable is objective assessment of the hand eczema severity performed at baseline prior to randomisation, and repeated at six months follow-up. Secondary outcome variables are dermatology related life quality and perceived global burden of disease.DiscussionThe trial aims at evaluating a newly developed guidance programme which is expected to support self-management of patients referred to dermatology treatment due to chronic hand eczema. The design of the protocol is pragmatic with blinding of neither participants nor the investigator. Thus, in the interpretation of the results, the investigator takes into account effects that may be attributed to actors of the interventions rather than the intervention per se as well of potential observer bias. Inclusion criterions are wide in order to increase transferability of the results.Trial registrationThe trial is registered in ClinicalTrials.Gov with registration number NCT01482663.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chronic hand eczema - self-management and prognosis: a study protocol for a randomised clinical trial

Mollerup

Veien²,

Johansen

2012

BMC Dermatol

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“…6 In short, heterogeneity considerably limits the comparability and overall confidence in the study results, and thereby the strength of recommendations for clinical practice. 7 To help overcome these problems, the Hand Eczema Core Outcome Set (HECOS) initiative was formed. This international working group of dermatologists and researchers experienced in hand eczema trials aims to develop a core outcome set for standardized evaluation of therapeutic and preventive interventions in future hand eczema trials and reviews.…”

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confidence: 99%

Which outcomes have been measured in hand eczema trials? A systematic review

et al. 2019

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The considerable heterogeneity of outcomes and measurement instruments in hand eczema trials substantially limits the evidence synthesis concerning therapeutic and preventive interventions. Therefore, the Hand Eczema Core Outcome Set (HECOS) initiative is developing a core outcome set for future trials. The first objective was to identify outcomes that were measured in previous trials, to group them in domains, and to identify their measurement instruments. We conducted a systematic review of controlled and randomized controlled hand eczema trials published since 2000. Sixty‐one eligible studies were identified. Each assessed one or more of 47 outcomes in the “skin” domain. Eighteen trials (30%) additionally focused on preventive behaviour in risk occupations. Quality of life was measured in 13 studies (21%). Thirty‐two distinct named instruments were applied, but 223 measurements (62%) were conducted with unnamed instruments. Only 32 studies (52%) defined a primary outcome. Twenty‐nine trials (48%) provided some information on adverse events, but none gave any references concerning relevant methods. Our review confirms the need to harmonize outcome measurements in hand eczema trials. The findings form the basis for a consensus process to generate a core outcome set to improve the explanatory power and comparability of future hand eczema studies.

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“…Workers who use barrier creams have better skin-quality scores and reduced transepidermal water loss than those who do not, 88,89 but this may not translate into a significant clinical difference. 90…”

Section: Protectionmentioning

confidence: 99%