Age Related, Structured Educational Programmes for the Management of Atopic Dermatitis in Children and Adolescents: Multicentre, Randomised Controlled Trial
Staab D, Diepgen TL, Fartasch M, et al. BMJ. 2006;332:933–938
PURPOSE OF THE STUDY. To determine the effects of age-related, structured educational programs on the management of moderate-to-severe atopic dermatitis in childhood and adolescence.
STUDY POPULATION. A total of 992 of 1010 patients who were eligible for the study were given random group assignment. Children aged 3 months to 18 years were enrolled in group sessions of standardized intervention programs for atopic dermatitis once weekly for 6 weeks in a multicenter trial in Germany.
METHODS. The study was a randomized, controlled intervention trial. The 3 participating groups were parents of children with atopic dermatitis who were 3 to 7, 8 to 12, or 13 to 18 years old. Participants were recruited from 7 hospitals in Germany. The inclusion criteria were (1) diagnosis of atopic dermatitis according to predefined criteria, (2) eczema duration of at least 3 months, and (3) severity of eczema of at least 20 points on the scoring-of-atopic-dermatitis scale. Each treatment group received a tailored (age-specific) educational program once weekly for 2 hours over the course of 6 weeks. The control groups did not receive any education. Participants in the intervention and control groups were followed up at 6 and 12 months. Primary outcome measures were the differences in severity of eczema based on the scoring-of-atopic-dermatitis scale as well as parents’ quality of life over 12 months.
RESULTS. Significant improvements in severity of eczema were seen in all intervention groups compared with control groups after 12 months on the basis of the severity score. Moreover, improvement in quality of life for mothers of children aged 3 months to 7 years was significantly greater in the intervention group for all 5 subscales of the quality-of-life questionnaire and for mothers of children aged 8 to 12 years for 3 of the subscales.
CONCLUSIONS. Age-related educational programs for the control of atopic dermatitis in children and adolescents are effective in the long-term management of the disease.
REVIEWER COMMENTS. This study showed that educational interventions that use a multidisciplined approach that addresses psychosocial, pharmacologic, and nutritional factors served to decrease the severity of atopic dermatitis in the intervention groups. However, severity of disease was seen to decrease as well in the control groups that did not participate in the interventional programs despite having similar pharmacologic interventions in both groups. The authors attributed this finding to the assumption that the control groups were also highly motivated and tried to optimize therapies. Nonetheless, such standardized educational/support groups seem to have beneficial consequences in children as well as parents dealing with this chronic illness.
- Copyright © 2007 by the American Academy of Pediatrics