Optimal management of atopic dermatitis (AD) requires patients to adhere to self-care behaviors. Technologies, such as cell phones, have been widely adopted in the USA and have potential to reinforce positive health behaviors. We conducted a pilot study with 25 adolescents and adults age 14 years and older [mean 30.5 yrs, SD 13.4] with AD. Daily text messages (TMs) that provided medication reminders and AD education were sent for six weeks to participants. Our goals were to (1) measure changes in pre- and posttest scores in treatment adherence, self-care behaviors, disease severity, and quality of life and (2) assess the usability and satisfaction of the TM system. Significant improvements in treatment adherence, self-care behaviors, skin severity, and quality of life (P ≤ .001, .002, <.001, and .014, resp.) were noted postintervention. User feedback on the TM system was positive with 88% and 92% of participants reporting that the reminder TMs and educational TMs were helpful, respectively. In conclusion, study participants were receptive to using TMs as a reminder aid and educational tool. The positive trends observed are promising and lay the ground work for further studies needed to elucidate the full potential of this simple and cost-effective intervention.

/pdf/text-messages-as-a-reminder-aid-and-educational-tool-in-118q2rpn2u.pdf

Text Messages as a Reminder Aid and Educational Tool in Adults and Adolescents with Atopic Dermatitis: A Pilot Study

Resume Introduction L’education therapeutique s’applique a de nombreuses maladies chroniques. Elle vise a ameliorer la prise en charge de ces maladies en developpant les competences des malades. La dermatite atopique est un champ de developpement de l’education therapeutique. L’objectif de ce travail etait de definir les competences propres a la gestion de la dermatite atopique pouvant faire l’objet d’une education therapeutique et de reunir ces competences sous forme d’un referentiel adapte a l’usage. Materiel et methode Trente soignants ont participe a la redaction de ce referentiel (dermatologues, medecin specialiste d’education therapeutique, psychologue, infirmieres). Tous avaient une experience en education therapeutique au cours de la dermatite atopique. Resultats Quatre tranches d’âge ont ete retenues (avant 5 ans, de 6 a 10 ans, pre adolescent/adultes, parents d’enfant de moins de 5 ans). Pour chaque tranche d’âge, les competences attendues des malades ou parents d’enfant et les methodes d’apprentissage adaptees ont ete choisies. Les competences ont ete classees en trois champs differents : (i) les connaissances (savoir) sur la maladie, les traitements, les facteurs declenchants, (ii) les savoir-faire : realisation des soins par les malades ou par les parents, (iii) les savoir etre : savoir expliquer la maladie et les soins aux proches, savoir quand et qui contacter. Enfin, un guide pour le diagnostic educatif en 10 questions a ete etabli. Discussion Nous rapportons les modalites d’elaboration et le contenu d’un referentiel de competences pour les malades atteints de dermatite atopique. Il ne s’agit pas d’exiger pour chaque malade l’ensemble des competences listees dans ce travail mais de mettre a disposition des soignants un referentiel complet permettant de choisir les competences a travailler au terme d’un diagnostic educatif. Ce referentiel s’adresse aux malades atteints de formes moderees a severes de dermatite atopique en situation d’echec therapeutique. Il est utilisable par toutes les personnes qui prennent en charge le malade : medecin, infirmiere ou psychologue selon les items explores. Il constitue un support a l’elaboration, a la diffusion et a l’evaluation d’un programme d’education therapeutique dans la dermatite atopique.

Dermatite atopique : un référentiel d'éducation du malade

Atopic eczema is a chronic disease with a severe impact on quality of life, and compliance is important for the course of the disease. During the last decade educational programmes have been increasingly popular, but only few randomized controlled trials evaluating the effect of educational programmes and eczema schools exist. These studies, however, indicate a high participant satisfaction and a positive influence on compliance.

Compliance among patients with atopic eczema.

Summary
Background

The systematic support of parents of children with eczema is essential to their effective management; however, we have few models of support This study examines the rationale, evidence base and development of a large-scale, structured, theory-based, nurse-led intervention, the ‘Eczema Education Programme’ (EEP), for parents of children with eczema



Objectives

To outline development of the EEP, model of delivery, determine its feasibility and evaluate this based on service access and parental satisfaction data



Methods

Parent–child dyads meeting EEP referral criteria were recruited and demographic information recorded A questionnaire survey of parental satisfaction was conducted 4 weeks post EEP; parental focus groups at 6 weeks provided comparative qualitative data Descriptive statistics were derived from the questionnaire data using Predictive Analytics Software (PASW); content analysis was applied to focus group data



Results

A total of 356 parents attended the EEP during the evaluation period Service access was achieved for those in a challenging population Both survey data (n = 146 parents, 57%) and focus group data (n = 21) revealed a significant level of parental satisfaction with the programme



Conclusions

It was feasible to provide the EEP as an adjunct to normal clinical care on a large scale, achieving a high level of patient/parent satisfaction and access within an urban area of multiple deprivation and high mobility The intervention is transferable and the results are generalizable to other ethnically diverse child eczema populations within metropolitan areas in Britain A multicentre RCT is required to test the effectiveness of this intervention on a larger scale

The Eczema Education Programme: intervention development and model feasibility.

Background

The notion of individual burden, associated with a disease, has been introduced to determine the ‘disability’ in the broadest sense (psychological, social, economic and physical). Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases with an estimated prevalence of 5%–30% in children.



Objective

To develop and validate a specific questionnaire which assess the burden of families of children with AD: the Atopic dermatitis Burden Scale (ABS).



Methods

Items for inclusion in ABS were initially generated from a literature review and a verbatim report from parents whose child had AD. ABS was refined via item reduction according to interquestion correlations, consensus among experts and exploratory factor analysis. Internal consistency was determined by calculating the Cronbach's α, concurrent validity by calculating the correlation between ABS and the Short-Form 12 items. Discriminant validity was analysed according to the severity degrees of AD assessed by Patient-Oriented SCORing index of Atopic Dermatitis (PO-SCORAD).



Results

From an initial list of 29 items, ABS was reduced to a 14-item questionnaire, grouped into four dimensions based on the exploratory factor analysis. Construct validity was demonstrated and ABS showed good internal coherence (Cronbach's α: 0.78). ABS was significantly correlated to the mental dimension of Short-Form 12 (r = −0.49), but it was not correlated to the physical dimension (r = 0.04). ABS scores were significantly different according to the severity degrees of AD, with higher ABS score in parents whose child had severe AD.



Conclusion

The ABS questionnaire is a validated tool for assessing the burden of families of children with AD. An implementation of a prospective study is planned to estimate sensitivity to change and to confirm its domain structure in larger samples.

Atopic dermatitis burden scale: creation of a specific burden questionnaire for families.

Introduction The assessment of the educational management of 40 moderate to severe atopic patients was performed in the atopic dermatitis school created in Nantes (France) from November 2000 to May 2001. Subjects and methods Patients with moderate to severe atopic dermatitis (SCORAD >20) were selected according to the criteria of Hanifin and Rajka and included in an open pilot study including a specific educational program. Atopic training included consultations, demonstrations, interviews with both dermatologist and nurses and workshops organized in three subgroups according to the age of the patients. SCORAD index, educational diagnosis and at least one educational objective were established during the first consultation. Evaluation criteria were defined in accordance with the educational objectives. Specific educational tools were used for each objective. Results Forty patients (mean age: 9 years) were followed during 6 months. At the beginning of the study the mean SCORAD was of 50.5. After a 6 months follow-up, the mean SCORAD was of 22 and improvement of the SCORAD was noted in 97 p. 100 of cases. Educational objectives were reached in 70.6 p. 100 of cases. One patient lost contact. Discussion The educational approach of atopic dermatitis includes global assessment of the disease after identification of risk factors, disrupted quality of life, skin-damaging behavior, family stress. Educational diagnosis focusing on local treatment is a major step; topical treatment is either misunderstood or conducted erroneously or non-existent. Therapeutic education plays a key role in the compliance and efficacy of treatment. Pain management, demonstration and explanation of skin care by health care professionals, information on the disease in age-specific workshops provided good results in more than 70 p. 100 of cases. Severe atopic dermatitis in children can lead to major domestic conflicts when the parents are in charge of the treatment. Giving responsibilities to the children, by teaching them how to treat themselves, relieves the parents from their involvement and finally reduces the conflicts. Conclusion The difficulties encountered in treating refractory atopic dermatitis may be secondary to the severity of the disease, to poor compliance or to the extent of the psychological impact. Therapeutic education of the patient, as performed in the atopic dermatitis school, represents a major breakthrough in the care of such patients.

[Assessment of an educational program in an "Atopic School": pilot study in 40 patients]

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[Assessment of an educational program in an "Atopic School": pilot study in 40 patients]