Where and how have written action plans for atopic eczema/dermatitis been developed and evaluated? Systematic review

Abstract

Background Atopic eczema/dermatitis is a common inflammatory condition which affects 15%–30% of children and 2%–10% of adults. It can have a significant impact and its management can be challenging. It is important for patients, parents, and caregivers to know how to look after their skin. Objectives To identify and review written eczema action plans (WAPs) that are available internationally for use by patients, parents, and caregivers. Methods We followed Preferred Reporting Items for Systematic reviews and Meta‐analysis guidelines. We searched relevant databases (MEDLINE, Embase, COCHRANE) from inception until March 2022. We sought grey literature via Google searches and professional networks. Database search results were independently reviewed by two different reviewers. With identified WAPs, we assessed length, appearance, content, how it was developed and whether it had been evaluated. Results From 312 abstracts, supplemented by other searches, we identified 20 unique eczema WAPs. From nine countries, all were written in English with 18 were designed for children. For the majority, it was unclear whether any development work preceded their creation or the intended clinical setting for use. Nineteen had a stepwise approach, 17 advised when to seek help, 6 were visually appealing and 6 had a rationale behind treatment documented in the WAP. Only three had been evaluated in clinical trials. Conclusion Further evaluation is needed to assess the effectiveness of the WAPs that currently exist, prior to creating further WAPs. Patient and caregiver involvement is needed in any future work.

A Mobile Health App for Facilitating Disease Management in Children With Atopic Dermatitis: Feasibility and Impact Study

“…A number of solutions have been offered to date to address barriers for poor medication adherence, such as patient education, medication simplification, and telemedicine. Research investigating action plans as educational tools for managing pediatric AD or teledermatology revealed that the effectiveness of these measures was either unexamined or considered insignificant [ 4 , 5 ], with a notable absence of reports on how treatment simplification impacts patients’ adherence. In a systematic review of 11 studies exploring the therapeutic adherence of mobile apps, 7 studies confirmed that use of the mobile app increased treatment adherence [ 6 ].…”