Therapeutic patient education in children with moderate to severe atopic dermatitis: A multicenter randomized controlled trial in China

Pediatr Dermatol. 2018 Jan;35(1):70-75. doi: 10.1111/pde.13362. Epub 2017 Dec 15.

Abstract

Background: Therapeutic patient education is a continuous, systematic, patient-centered learning process to help patients and their families acquire and maintain the skills they need to manage their lives with a chronic disease. It has been proven effective in increasing treatment adherence and improving quality of life for patients with atopic dermatitis (AD) in Western countries. We introduce the first multicenter, randomized controlled clinical trial of therapeutic patient education in Chinese children with AD.

Objectives: To evaluate the effects of therapeutic patient education on the severity of AD, quality of life, and understanding and successful use of emollients in Chinese children with eczema.

Methods: We recruited 580 children, ages 2-14 years, with moderate to severe AD from six hospitals in China. Participants were randomized (1:1) to an intervention (n = 293) or control (n = 249) group. In addition to the severity of AD, data on quality of life and a questionnaire on family and patient knowledge of emollients were evaluated at the 6-month follow-up.

Results: On study completion, we found that the intervention group showed a significantly greater reduction in mean SCORing Atopic Dermatitis (P < .001) and Infant's Dermatology Life Quality Index (P = .030) scores than the control group. In addition, knowledge about the use of emollients improved significantly in the intervention group. There was no significant difference between groups in Children's Dermatology Life Quality Index scores.

Conclusions: The first randomized controlled trial of a therapeutic patient education program in China had positive long-term effects on decreasing eczema severity and improvement of quality of life in children 2-4 years of age with AD, as well as in promoting greater understanding of the use of emollients.

Keywords: atopic dermatitis; eczema; quality of life.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Child
  • Child, Preschool
  • China
  • Dermatitis, Atopic / therapy*
  • Emollients / therapeutic use*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Parents / education
  • Patient Education as Topic / methods*
  • Program Evaluation
  • Quality of Life / psychology
  • Severity of Illness Index

Substances

  • Emollients