New research suggests that 2 online behavioral interventions offered to patients with atopic dermatitis, in addition to their normal care, have been shown to provide lasting benefits.
The effects on the quality of life of patients with atopic eczema, also known as atopic dermatitis, are noted in the study as significant and often requiring a variety of interventions. Investigators cite that self-management is important, but there is a lack of information about online interventions developed for patients with eczema.
The study was designed to provide a greater amount of data on 2 specific online interventions, and the study was led by Miriam Santer, MD, of the Primary Care Research Center at the University of Southampton.
“We evaluated two online behavioral interventions to support eczema self-management: one aimed at parents or caregivers of children with eczema, and the other aimed at young people with eczema,” writes Santer and his colleagues. “As parents and carers of children and young people with eczema are likely to have different support needs, we developed two separate interventions to be evaluated in two independent randomized controlled trials.”
Background and research
The study was a set of 2 individually randomized multicenter trials, with online interventions designed and delivered through LifeGuide software. They recruited 340 parents or guardians for one arm and 337 children with eczema for the other, dividing them into ‘usual care’ or ‘intervention’ arms.
The two online interventions were developed separately but in parallel, with one aimed at parents or guardians of children with atopic dermatitis, and the other designed for young eczema patients themselves. The researchers noted that their interventions were designed to be conducted entirely online and designed to be self-guided, so those involved could use the intervention tools as needed.
The main focus of the investigators for their interventions was supposed to be the reduction of eczema severity as well as the development of basic behaviors to address eczema management. This included the following:
- Regular use of emollients
- Appropriate use of topical corticosteroids
- Minimization of scratches
The interventions themselves were designed by a team of clinicians (general practitioners, dermatology nurse consultants, dermatologists), behavioral psychologists, patient representatives and researchers. They were then adapted for patients through user feedback collected to ensure they worked and were practical, as well as useful.
Study results indicated that at week 24, follow-up rates for study participants were 91.5%, or 311 out of 340, for parents or guardians. The rate in young eczema patients was 90.2%, or 304 out of 337).
The researchers, after controlling for baseline eczema severity and other variables, compared the intervention groups to usual care groups over 24 weeks, finding that eczema severity improved in the treatment groups. ‘intervention. They noted that the mean difference in Patient-Oriented Eczema Measure (POEM) score was -1.5 for parents or guardians (95% confidence interval, -2.5 to -0.6; P=0.002) and −1.9 for children (−3.0 to −0.8; P<0.001).
The investigators also noted that the improvements seen in the patients after the interventions were also maintained for up to 52 weeks for both trials. The team’s subgroup analyzes for each trial demonstrated that people in the intervention group had similar eczema outcomes regardless of gender, age, severity of condition, baseline treatment use, prior belief in the usefulness of the intervention, or even prior use of other atopic dermatitis websites.
“Few fully powered trials have been conducted of self-management or educational interventions for eczema, and those that have been published have used different outcome measures, making direct comparisons difficult,” they said. writing. “However, much more expensive educational interventions have shown only modest improvements in eczema, and we believe the size of the effect in our trials compares favorably to more intensive interventions.”
The study, “Eczema Care Online behavioral interventions to support self-care for children and young people: two Independent, pragmatic, randomized controls,” was published online in The BMJ.
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