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J Allergy Clin Immunol. 2017 Sep;140(3):845-853.e3. doi: 10.1016/j.jaci.2017.01.029. Epub 2017 Feb 24.

Effects of structured patient education in adults with atopic dermatitis: Multicenter randomized controlled trial.

Author information

1
Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany. Electronic address: Heratizadeh.Annice@mh-hannover.de.
2
Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
3
Department of Dermatology and Allergy, Ludwig-Maximilian-Universität Munich, Munich, Germany.
4
Department of Dermatology, Medical Faculty Carl-Gustav-Carus, Technical University of Dresden, Dresden, Germany.
5
Department of Dermatology and Allergology, Vital Klinik GmbH & Co. KG, Alzenau, Germany.
6
Department of Dermatology and Allergology Biederstein, Technical University Munich, Munich, Germany.
7
Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany.
8
Department of Clinical Social Medicine, University Hospital Heidelberg, Heidelberg, Germany; Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
9
Department of Dermatology and Allergology Biederstein, Technical University Munich, Munich, Germany; Department of Dermatology, Eberhard Karls University, Tübingen, Germany.
10
Department of Allergology and Occupational Dermatology, Dermatologikum Hamburg, Hamburg, Germany.
11
Dermatology Centre of Rehabilitation and Prevention GmbH Bad Soden, Bad Soden, Germany.
12
Department of Dermatology, Universitätsklinikum Schleswig-Holstein, Campus Kiel Dermatologie, Venerologie und Allergologie, Kiel, Germany.
13
Department of Dermatology and Allergy, Campus Mitte, Charité Universitätsmedizin, Berlin, Germany.
14
Dermatologisches Zentrum Buxtehude, Buxtehude, Germany.
15
Psychological Practice, Academy of Neurodermatitis Hessen, Hessen, Germany.
16
Nutrition Counselling Allergology, Munich, Germany.
17
Department of Dermatology and Allergology Biederstein, Technical University Munich, Munich, Germany; Christine Kuehne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.
18
Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany.
19
Center for Evidence-based Healthcare, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Germany.
20
Department of Psychosomatic Medicine, University Leipzig, Leipzig, Germany.
21
Department of Dermatology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany.
22
Klinikum Darmstadt Bereich Eberstadt Hautklinik, Darmstadt, Germany.
23
Department of Clinical Social Medicine, University Hospital Heidelberg, Heidelberg, Germany.
24
Department of Dermatology and Allergology, Justus-Liebig-University Giessen, Giessen, Germany.
25
Institute of Medical Psychology, Justus-Liebig-University Giessen, Giessen, Germany.

Abstract

BACKGROUND:

Atopic dermatitis (AD) is a chronic relapsing skin disease prevalent in 1% to 3% of adults in Western industrialized countries.

OBJECTIVE:

We sought to investigate the effectiveness of educational training in an outpatient setting on coping with the disease, quality of life, symptoms, and severity in adults with AD.

METHODS:

In this German prospective, randomized controlled multicenter study, adult patients with moderate-to-severe AD were educated by referring to a comprehensive 12-hour training manual consented by a multiprofessional study group from different centers (Arbeitsgemeinschaft Neurodermitisschulung für Erwachsene [ARNE]). Patients were randomly allocated to the intervention or waiting control groups. Study visits were performed at baseline and after 1 year (1 year of follow-up). Primary outcomes were defined as a decrease in (1) "catastrophizing cognitions" with respect to itching (Juckreiz-Kognitions-Fragebogen questionnaire), (2) "social anxiety" (Marburger Hautfragebogen questionnaire), (3) subjective burden by symptoms of the disease (Skindex-29 questionnaire), and (4) improvement of disease signs and symptoms assessed by using the SCORAD index at 1 year of follow-up. Data were analyzed on an intention-to-treat basis.

RESULTS:

At 1 year of follow-up, patients from the intervention group (n = 168) showed a significantly better improvement compared with the waiting group (n = 147) in the following defined primary study outcomes: coping behavior with respect to itching (P < .001), quality of life assessed by using the Skindex-29 questionnaire (P < .001), and the SCORAD index (P < .001).

CONCLUSIONS:

This is the first randomized, controlled multicenter study on patient education in adult AD. The ARNE training program shows significant beneficial effects on a variety of psychosocial parameters, as well as AD severity.

KEYWORDS:

Atopic dermatitis; adulthood; coping; disease severity; multi-professional; patient education; psychosocial; quality of life

PMID:
28242304
DOI:
10.1016/j.jaci.2017.01.029
[Indexed for MEDLINE]

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