Parental Response to Written Eczema Action Plans in Children With Eczema

Rork, Jillian F.; Sheehan, William J.; Gaffin, Jonathan M.; Timmons, Karol; Sidbury, Robert; Schneider, Linda C.; Phipatanakul, Wanda

doi:10.1001/archdermatol.2011.2267

Cited by 48 publications

(44 citation statements)

References 6 publications

(7 reference statements)

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“…33 Written action plans have been shown to improve adherence in children with asthma, and a similar model for patients with AD (see Fig 1 for an example), outlining specific indications for different products and medications, is likely to be helpful. 34,35 Maintenance Skin Care…”

Section: Treatment Principlesmentioning

confidence: 99%

Atopic Dermatitis: Skin-Directed Management

Tollefson¹,

Bruckner²,

Dermatology³

2014

Pediatrics

108

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Atopic dermatitis is a common inflammatory skin condition characterized by relapsing eczematous lesions in a typical distribution. It can be frustrating for pediatric patients, parents, and health care providers alike. The pediatrician will treat the majority of children with atopic dermatitis as many patients will not have access to a pediatric medical subspecialist, such as a pediatric dermatologist or pediatric allergist. This report provides up-to-date information regarding the disease and its impact, pathogenesis, treatment options, and potential complications. The goal of this report is to assist pediatricians with accurate and useful information that will improve the care of patients with atopic dermatitis. Pediatrics 2014;134:e1735-e1744Atopic dermatitis (AD), commonly referred to as eczema, is a chronic, relapsing, and often intensely pruritic inflammatory disorder of the skin. A recent epidemiologic study using national data suggested that the pediatric prevalence is at least 10% in most of the United States. 1 AD primarily affects children, and disease onset occurs before the ages of 1 and 5 years in 65% and 85% of affected children, respectively. 1 The number of office visits for children with AD is increasing. 2 Up to 80% of children with AD are diagnosed and managed by primary care providers, often pediatricians. 3 Although medical subspecialists, such as pediatric dermatologists and/or pediatric allergists, may be suited to provide more advanced care for children with AD, lack of a sufficient number of such physicians, particularly pediatric dermatologists, 4 likely means the burden of AD care will continue to fall to primary care providers. Although consensus guidelines and practice parameters regarding the management of AD in children have been published, 5-10 considerable variability persists in clinical practice, particularly regarding the roles that bathing, moisturizing, topical medications, and allergies play in management. Inconsistencies in opinion and treatment approach as well as the chronic and relapsing nature of AD can lead to frustration for the patient, family, and primary care providers when managing AD. STATEMENT OF THE PROBLEMNew data support the theory that AD results from primary abnormalities of the skin barrier, 11 suggesting that skin-directed management of AD is of paramount importance. This clinical report reviews AD and provides an up-to-date approach to skin-directed management that is based on pathogenesis. Effectively using this information to create treatment plans

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Section: Treatment Principlesmentioning

confidence: 99%

Atopic Dermatitis: Skin-Directed Management

Tollefson¹,

Bruckner²,

Dermatology³

2014

Pediatrics

108

View full text Add to dashboard Cite

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“…In addition, written eczema action plans may be beneficial by enabling eczema self-management by reminding patients and caregivers of maintenance regimens and additional therapies to incorporate during flares. 13 …”

Section: Treatmentmentioning

confidence: 99%

Child with atopic dermatitis

Kanchongkittiphon

Gaffin

Phipatanakul

2015

Annals of Allergy, Asthma & Immunology

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“…The studies by Rork et al [14], Moore et al [12], Grillo et al [15], Shaw et al [13], and Chinn et al [17] measured disease severity using the SCORAD (Scoring of Atopic Dermatitis) index and/or quality of life instead of directly measuring adherence. It was assumed that improved severity and/or improved quality of life was caused by increased adherence to the medication.…”

Section: Resultsmentioning

confidence: 99%

Interventions to Increase Treatment Adherence in Pediatric Atopic Dermatitis: A Systematic Review

Bass

Anderson

Feldman

2015

JCM

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Poor adherence to treatment is a major factor limiting treatment outcomes in patients with atopic dermatitis. The purpose of our systematic review is to identify techniques that have been tested to increase treatment adherence in atopic dermatitis. A MEDLINE search was performed for clinical trials focusing on interventions used to increase adherence in atopic dermatitis. Four articles were retrieved. References of these studies were analyzed yielding three more trials. The seven results were evaluated by comparing the intervention used to improve adherence, how adherence was assessed, and the outcome of the intervention tested. Different approaches to increase adherence such as written eczema action plans, educational workshops, extra office visits, and use of an atopic dermatitis educator were evaluated. All interventions increased adherence rates or decreased severity in patients, except for two. The MEDLINE search yielded limited results due to a lack of studies conducted specifically for atopic dermatitis and adherence was measured using different methods making the studies difficult to compare. Interventions including patient education, eczema action plans, and a quick return for a follow-up visit improve adherence, but based on the lack of clinical trials, developing new techniques to improve adherence could be as valuable as developing new treatments.

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Parental Response to Written Eczema Action Plans in Children With Eczema

Cited by 48 publications

References 6 publications

Atopic Dermatitis: Skin-Directed Management

Atopic Dermatitis: Skin-Directed Management

Child with atopic dermatitis

Interventions to Increase Treatment Adherence in Pediatric Atopic Dermatitis: A Systematic Review

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