Age-related educational programs for the long-term control of atopic dermatitis in children and adolescents were significantly more effective than conventional treatment, according to a randomized controlled trial of 823 parents and affected patients in Germany.
Atopic dermatitis affects up to one-fifth of schoolchildren. Management of this chronic disease may be suboptimal due to lack of information and lack of confidence in medical treatment. While several educational interventions have been developed for adults with eczema, programs for children are sparse.
In this study, an interdisciplinary team presented standardized educational programs for the management of atopic dermatitis. Those in the intervention group participated in six weekly group sessions lasting two hours each. Participants were grouped by age: parents of children ages 3 months to 7 years; parents of 8- to 12-year-olds; and adolescents ages 13 to 18 years.
Topics included basic medical information; stress reduction, dealing with itching and scratching, and sleep disturbance; recognition and avoidance of trigger factors, daily skin care; stage-related treatment of symptoms, unconventional therapies; general child nutrition, food allergies in atopic dermatitis; and issues of coping, self-management plan.
Parents and affected adolescents completed questionnaires before the intervention began and 12 months later that assessed subjective severity of eczema, itching behavior and quality of life for parents of children younger than 13. The study also assessed clinical severity of eczema.
Significant improvements in clinical severity of eczema and subjective severity were seen in all intervention groups compared with the control group. In addition, parents of children younger than 7 years of age experienced significantly better improvement in all five quality of life subscales (psychosomatic well-being, effects on social life, confidence in medical treatment, emotional coping and acceptance of disease) compared with the control group. Parents of children ages 8 to 12 years experienced significantly better improvement in confidence in medical treatment, emotional coping and acceptance of the disease.
The authors concluded that integrating educational programs for the control of atopic dermatitis with routine care should be considered.
Source: http://aapnews.aappublications.org
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