Texting atopic dermatitis patients to optimize learning and eczema area and severity index scores: A pilot randomized control trial

Pediatr Dermatol. 2018 Jul;35(4):453-457. doi: 10.1111/pde.13510. Epub 2018 May 2.


Background/objectives: Atopic dermatitis is a common, chronic, debilitating disease. Poor adherence to treatment is the most important preventable contributor to adverse outcomes. Thus, improving adherence can improve patient outcomes. Text message reminders with embedded condition-specific information have been shown to improve pediatric immunization adherence but have not been assessed in atopic dermatitis. The objective was to assess the effect of daily text messages on Eczema Area Severity Index scores and caregiver knowledge of atopic dermatitis.

Methods: In this pilot randomized controlled trial, caregivers of children with atopic dermatitis enrolled during their initial appointment with a pediatric dermatologist and randomized 1:1 to standard care or daily text messages with patient education material and treatment reminders. Participants completed a multiple-choice atopic dermatitis knowledge quiz at initial and follow-up visits, and Eczema Area Severity Index scores were assessed.

Results: Forty-two patients enrolled, and 30 completed the study: 16 standard care group, 14 text message group. There was no significant difference in Eczema Area Severity Index score between the standard care and text message groups at follow-up, with mean decreases in Eczema Area Severity Index score of 53% and 58%, respectively. Mean score on follow-up atopic dermatitis knowledge quiz was significantly higher in the text message group (84% correct) than in the standard care group (75% correct) (P = .04).

Conclusion: This pilot study did not demonstrate a difference in Eczema Area Severity Index scores with text message reminders. The significantly higher follow-up atopic dermatitis quiz score in the text message group indicates that participants read and retained information from text messages. Limitations include small sample size and short duration of follow-up.

Keywords: atopic dermatitis; eczema; health care delivery; text messages.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Caregivers
  • Child, Preschool
  • Dermatitis, Atopic / therapy*
  • Eczema / therapy
  • Female
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Infant
  • Male
  • Patient Compliance / statistics & numerical data*
  • Patient Education as Topic / methods*
  • Pilot Projects
  • Severity of Illness Index
  • Text Messaging*