Pediatric Atopic Eczema: The Impact of an Educational Intervention

Grillo, Marianne; Gassner, Lee; Marshman, Gillian; Dunn, Sandra; Hudson, Pamela

doi:10.1111/j.1525-1470.2006.00277.x

Cited by 132 publications

(210 citation statements)

References 18 publications

(29 reference statements)

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“…There was a reduction in quality-of-life scores (better quality of life) in the education programme groups compared with the control groups in three [351][352][353] of the six trials. In the trial by Grillo and colleagues 353 the CDLQI at 12 weeks reduced by 7.35 points in the intervention group (education session in addition to normal care) and 2.61 points in the control group (normal care only) (p = 0.004).…”

Section: Quality Of Lifementioning

confidence: 99%

“…The trial reported by Grillo and colleagues 353 involved 61 children with eczema and their parents. The trial compared a 2-hour group education session in addition to normal care with normal care alone.…”

Section: Non-pharmacological Interventionsmentioning

confidence: 99%

“…Six new studies reported since 2000 [350][351][352][353][354][355] have looked at eczema education sessions for children, parents and carers, with all using slightly different approaches. Overall, the interventions in this section are quite diverse with regard to the components and intensity of the interventions, with time spent on the education ranging from 15 minutes to 2 weeks.…”

Section: (See Appendix 3)mentioning

confidence: 99%

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Scoping systematic review of treatments for eczema

Nankervis

Kim

Delamere

et al. 2016

Programme Grants Appl Res

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BackgroundEczema is a very common chronic inflammatory skin condition.ObjectivesTo update the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) systematic review of treatments for atopic eczema, published in 2000, and to inform health-care professionals, commissioners and patients about key treatment developments and research gaps.Data sourcesElectronic databases including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Skin Group Specialised Register, Latin American and Caribbean Health Sciences Literature (LILACS), Allied and Complementary Medicine Database (AMED) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched from the end of 2000 to 31 August 2013. Retrieved articles were used to identify further randomised controlled trials (RCTs).Review methodsStudies were filtered according to inclusion criteria and agreed by consensus in cases of uncertainty. Abstracts were excluded and non-English-language papers were screened by international colleagues and data were extracted. Only RCTs of treatments for eczema were included, as other forms of evidence are associated with higher risks of bias. Inclusion criteria for studies included availability of data relevant to the therapeutic management of eczema; mention of randomisation; comparison of two or more treatments; and prospective data collection. Participants of all ages were included. Eczema diagnosis was determined by a clinician or according to published diagnostic criteria. The risk of bias was assessed using the Cochrane Collaboration risk-of-bias tool. We used a standardised approach to summarising the data and the assessment of risk of bias and we made a clear distinction between what the studies found and our own interpretation of study findings.ResultsOf 7198 references screened, 287 new trials were identified spanning 92 treatments. Trial reporting was generally poor (randomisation method: 2% high, 36% low, 62% unclear risk of bias; allocation concealment: 3% high, 15% low, 82% unclear risk of bias; blinding of the intervention: 15% high, 28% low, 57% unclear risk of bias). Only 22 (8%) trials were considered to be at low risk of bias for all three criteria. There was reasonable evidence of benefit for the topical medications tacrolimus, pimecrolimus and various corticosteroids (with tacrolimus superior to pimecrolimus and corticosteroids) for both treatment and flare prevention; oral ciclosporin; oral azathioprine; narrow band ultraviolet B (UVB) light; Atopiclair™ and education. There was reasonable evidence to suggest no clinically useful benefit for twice-daily compared with once-daily topical corticosteroids; corticosteroids containing antibiotics for non-infected eczema; probiotics; evening primrose and borage oil; ion-exchange water softeners; protease inhibitor SRD441 (Serentis Ltd); furfuryl palmitate in emollient; cipamfylline cream; andMycobacterium vaccaevaccine. Additional research evidence is needed for emollients, bath additives, antibacterials, specialist clothing and complementary and alternative therapies. There was no RCT evidence for topical corticosteroid dilution, impregnated bandages, soap avoidance, bathing frequency or allergy testing.LimitationsThe large scope of the review coupled with the heterogeneity of outcomes precluded formal meta-analyses. Our conclusions are still limited by a profusion of small, poorly reported studies.ConclusionsAlthough the evidence base of RCTs has increased considerably since the last NIHR HTA systematic review, the field is still severely hampered by poor design and reporting problems including failure to register trials and declare primary outcomes, small sample size, short follow-up duration and poor reporting of risk of bias. Key areas for further research identified by the review include the optimum use of emollients, bathing frequency, wash products, allergy testing and antiseptic treatments. Perhaps the greatest benefit identified is the use of twice weekly anti-inflammatory treatment to maintain disease remission. More studies need to be conducted in a primary care setting where most people with eczema are seen in the UK. Future studies need to use the same core set of outcomes that capture patient symptoms, clinical signs, quality of life and the chronic nature of the disease.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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Section: Quality Of Lifementioning

confidence: 99%

Section: Non-pharmacological Interventionsmentioning

confidence: 99%

Section: (See Appendix 3)mentioning

confidence: 99%

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Scoping systematic review of treatments for eczema

Nankervis

Kim

Delamere

et al. 2016

Programme Grants Appl Res

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“…A therapeutic intervention, i.e. providing parents with more information on atopic dermatitis-related disorders and skin care methods (Therapeutic Patient Education -TPE), results in an increase in adherence, decrease of SCORAD, better quality of life [36][37][38][39] and higher satisfaction with treatment [12]. Improved doctor-parent interaction increases adherence, effectiveness of the therapy and treatment satisfaction of AD [21,40].…”

Section: Analiza Zależności Pomiędzy Przestrzeganiem Zaleceń a Satysfmentioning

confidence: 99%

Satisfaction with treatment of atopic dermatitis in children

Maciejewska-Franczak¹,

Majak²,

Kaczmarek³

et al. 2016

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Introduction. Atopic dermatitis is a frequent chronic skin disease in children. The major clinical manifestations include itching and dryness of the skin. The pathomechanism of skin changes results from an interaction of genetic and environmental factors as well as impairments of skin barrier function and immune response. Despite chronic treatment the disease is characterized by exacerbation and remission periods and lowers the quality of life of patients and their families. Objective. To evaluate treatment satisfaction in children with atopic dermatitis, identify components of medical care which contribute to treatment satisfaction, and evaluate the relationship between satisfaction and adherence to a doctor's recommendations. Material and methods. One hundred and nineteen children (6 months to 12 years old, mean age 4.9 years) with atopic dermatitis were enrolled in the study. The doctor performed physical examinations and history taking and filled in questionnaires evaluating the course and exacerbation of the disease, the type of administered therapy and diagnostics. The patients' parents completed two questionnaires: a questionnaire assessing satisfaction with the therapy (the type of recommended therapy, adherence to recommendations, contact with the doctor, obtained information, degree of psychological support, role of parents in taking decisions regarding the therapy) and a quality of life questionnaire. Results. The authors observed that 56% of parents were dissatisfied with the administered treatment, and 40% failed to adhere to at least one therapeutic recommendation. Parents of children with mild atopic dermatitis significantly more often stop using emollients. It was also observed that lack of treatment satisfaction in children with severe atopic dermatitis whose parents are insufficiently educated contributes to decreased adherence. The authors identified independent factors of lack of treatment satisfaction: failure to obtain enough psychological support (OR = 20.00), failure to obtain reliable information on the disease (OR = 5.91), failure to actively get engaged in the treatment procedure (OR = 5.31), dissatisfaction with the contact with the doctor (OR = 4.9), dissatisfaction with the diagnostics (OR = 4.93) and severe course of the disease (OR = 2.82). Conclusions. Elimination of risk factors of dissatisfaction with the treatment might potentially improve the adherence to chronic treatment in atopic dermatitis. atopic dermatitis, satisfaction with treatment. Wprowadzenie. Atopowe zapalenie skóry (AZS) jest częstą przewlekłą chorobą skóry u dzieci. Głównymi objawami klinicznymi są suchość skóry i świąd. Patomechanizm zmian skórnych jest wynikiem interakcji między czynnikami genetycznymi, środowiskowymi, zaburzeniami funkcjonowania bariery skórnej a odpowiedzią immunologiczną. Pomimo stosowania przewlekłego leczenia choroba przebiega z okresami zaostrzeń i remisji, obniża jakość życia pacjentów i ich rodzin. Cel pracy. Próba zdefiniowania składowych opieki medycznej, które mają wpływ n...

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“…Supporting parents in dealing with the management of AD presents a challenge for physicians 1 . Educational programs for parents and patients with AD have been established in the last ten years in different European countries [3][4][5][6] . Standardized interdisciplinary programs involving dermatologists, pediatricians, psychologists and dietitians improve symptoms and clinical manifestations of AD by optimizing the use of medications resulting in better compliance and leading to a significant increase in the quality of life (QoL) 7 .…”

Section: Introductionmentioning

confidence: 99%

Importance of Educational Intervention and Parental Knowledge on Atopic Dermatitis in Children

Kotrulja¹

2016

ACC

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SUMMARY -Atopic dermatitis (AD) is a chronic relapsing, inflammatory skin disease. Failure to treat AD successfully can often be directly linked to poor treatment adherence as a result of the lack of information about the disease and basic principles of treatment. Several studies have found that making patients active participants in their care through information and education is a successful treatment strategy in AD. The aim of this study was to evaluate parental knowledge on AD and to stress the importance of therapeutic educational program in long term management and control of the disease. We carried out a short questionnaire-based study among 238 parents of children with AD regarding their knowledge on the etiology and treatment of AD. Our results showed that 21% of the participants reported corticophobia and were concerned about systemic absorption affecting the child's growth and development even after short application. In children with AD who have food hypersensitivity, 14% of parents thought that a small amount of food allergen could be beneficial in achieving tolerability. The role of interdisciplinary educational program is to explain the epidemiology and pathogenesis of AD, as well as concomitant atopy related diseases and to teach parents about the importance of appropriate skin care.

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Pediatric Atopic Eczema: The Impact of an Educational Intervention

Cited by 132 publications

References 18 publications

Scoping systematic review of treatments for eczema

Scoping systematic review of treatments for eczema

Satisfaction with treatment of atopic dermatitis in children

Importance of Educational Intervention and Parental Knowledge on Atopic Dermatitis in Children

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