The Effectiveness of Tailored Education on the Usage of Moisturizers in Atopic Dermatitis: A Pilot Study.
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ABSTRACT:
SUBMITTER: Park GY
PROVIDER: S-EPMC5438950 | biostudies-literature | 2017 Jun
REPOSITORIES: biostudies-literature
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The Effectiveness of Tailored Education on the Usage of Moisturizers in Atopic Dermatitis: A Pilot Study.
Park Gyeong Yul GY Park Hyun-Sun HS Cho Soyun S Yoon Hyun-Sun HS
Annals of dermatology 20170511 3
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Project description:BackgroundAtopic dermatitis (AD) is a chronic inflammatory skin disease that affects children and adults. Poor treatment adherence in AD requires interventions to promote self-management; patient education in chronic diseases is key to self-management. Many international AD management guidelines published to date include a recommendation for educating patients as part of their treatment but there are no formal recommendations on how to deliver this knowledge. MAIN: We performed a scoping review to map the existing literature on patient education practices in AD and to highlight the clinical need for improved patient education in AD. The literature search was performed with the online databases MEDLINE, Embase, Grey Matters, ClinicalTrails.gov and the International Clinical Trials Registry Platform (ICTRP). The search strategy yielded 388 articles. Of the 388 articles screened, 16 studies met the eligibility criteria, and the quantitative data was summarized by narrative synthesis. The majority of studies were randomized controlled trials conducted in Europe, Asia and North America. Since 2002, there have been limited studies evaluating patient education in the treatment of AD. Frequent education methods used included group-based educational programs, educational pamphlets, individual consultations and online resources. Education was most commonly directed at caregivers and their children. Only one study compared the efficacy of different education methods. In all included studies, the heterogenous nature of outcome measures and study design limited the consistency of results. Despite the heterogeneity of studies, patient education was shown to improve quality of life (QoL), disease severity and psychological outcomes in AD patients.ConclusionThis scoping review highlights that patient education is effective in a variety of domains relevant to AD treatment. Further comparative studies and randomized trials with longer-term follow-up are needed to provide validated and consistent patient education recommendations for AD; these may depend on age and population.
| S-EPMC10576377 | biostudies-literature
Project description:Background/objectivesPediatricians manage skin conditions such as atopic dermatitis (AD) but report that their dermatologic training is inadequate. Online modules may enhance medical education when sufficient didactic or clinical teaching experiences are lacking. We assessed whether an online module about AD improved pediatric residents' knowledge and changed their clinical management of AD.MethodsTarget and control cohorts of pediatric residents from two institutions were recruited. Target subjects took a 30-question test about AD early in their residency, reviewed the online module, and repeated the test 6 months and 1 year later. The control subjects, who had 1 year of clinical experience but had not reviewed the online module, also took the test. The mean percentage of correct answers was calculated and compared using two-sided, two-sample independent t tests and repeated-measures analysis of variance. For a subset of participants, clinical documentation from AD encounters was reviewed and 13 practice behaviors were compared using the Fisher exact test.ResultsTwenty-five subjects in the target cohort and 29 subjects in the control cohort completed the study. The target cohort improved from 18.0 ± 3.2 to 23.4 ± 3.4 correctly answered questions over 1 year (P < .001). This final value was greater than that of the control cohort (20.7 ± 4.5; P = .01). Meaningful differences in practice behaviors were not seen.ConclusionPediatric residents who reviewed an online module about AD demonstrated statistically significant improvement in disease-specific knowledge over time and had statistically significantly higher scores than controls. Online dermatology education may effectively supplement traditional clinical teaching.
| S-EPMC5777881 | biostudies-literature
Project description:Atopic dermatitis is a chronic skin disease affecting quality of life, sleep, and mental health. Traditional evaluation methods focus on clinical assessments, but there is a growing need for tools that incorporate patient-reported outcomes (PROs). To evaluate the effectiveness of the Atopic Dermatitis Control Tool (ADCT) in assessing disease severity in patients with moderate to severe atopic dermatitis and to compare the efficacy of systemic immunosuppressants and dupilumab in patients with moderate to severe atopic dermatitis. A prospective, observational study was conducted across seven centres in Korea, involving 112 patients with moderate to severe atopic dermatitis. The ADCT, Eczema Area and Severity Index (EASI), and Dermatology Life Quality Index (DLQI) were used for assessing atopic dermatitis severity. In addition, the study assessed the effectiveness of immunosuppressants and dupilumab over the course of one year. The study found significant correlations between ADCT scores and other severity measures (EASI, DLQI). The correlation coefficients were 0.54 (p < 0.0001) for ADCT vs EASI and 0.83 (p < 0.0001) for ADCT vs DLQI. Furthermore, patients treated with dupilumab exhibited greater improvement compared with those on cyclosporine, as measured by the ADCT (adjusted OR [95% CI]); 6.98 [2.49, 19.58]). The ADCT effectively captures subjective aspects compared with the EASI and can be used practically and effectively in clinical settings of atopic dermatitis.
| S-EPMC11833179 | biostudies-literature
Project description:BackgroundPrevention strategies in atopic dermatitis (AD) using allergen avoidance have not been consistently effective. New research reveals the importance of the skin barrier in the development of AD and possibly food allergy and asthma. Correcting skin barrier defects from birth may prevent AD onset or moderate disease severity.ObjectiveWe sought to determine the feasibility of skin barrier protection as a novel AD prevention strategy.MethodsWe enrolled 22 neonates at high risk for developing AD in a feasibility pilot study using emollient therapy from birth.ResultsNo intervention-related adverse events occurred in our cohort followed up for a mean time of 547 days. Of the 20 subjects who remained in the study, 3 (15.0%) developed AD, suggesting a protective effect when compared with historical controls. Skin barrier measurements remained within ranges seen in normal-appearing skin.LimitationsNo conclusions regarding efficacy can be made without a control group.ConclusionsSkin barrier repair from birth represents a novel and feasible approach to AD prevention. Further studies are warranted to determine the efficacy of this approach.
| S-EPMC3156679 | biostudies-literature
Project description:Background:Saline groundwater, collected from the east coast of Korea, has been shown to have protective effects against 2,4-dinitrochlorobenzene- (DNCB-) induced atopic dermatitis-like skin lesions in the murine model. Objectives:To determine the effects of saline groundwater solution baths as a treatment of mild-to-moderate atopic dermatitis. Methods:Twenty-four subjects with mild-to-moderate atopic dermatitis were instructed to take a bath in saline groundwater solution for 20 minutes per day for two weeks. Evaluations were performed at baseline and week 2, including SCORing Atopic Dermatitis (SCORAD) index, corneometry, transepidermal water loss, visual analogue scale for pruritus, and collection of adverse events. Results:Subjects showed significant improvement with respect to the SCORAD index, skin hydration, transepidermal water loss, and pruritus at week 2 when compared with the baseline. Conclusion:Baths in saline groundwater solution may be an alternative therapeutic strategy for treating atopic dermatitis.
| S-EPMC7303733 | biostudies-literature
Project description:ObjectiveTo investigate the preliminary safety and efficacy of apremilast, an oral phosphodiesterase 4 inhibitor, for atopic dermatitis.DesignThis investigator-initiated, open-label pilot study evaluated 2 doses of apremilast in patients with atopic dermatitis. Differential gene analysis was performed from peripheral whole blood using data before and after treatment.SettingUniversity-based dermatology clinical research unit.PatientsSixteen adult patients with atopic dermatitis.InterventionA specific phosphodiesterase 4 inhibitor, apremilast.Main outcome measuresThe primary outcome was incidence of adverse events. Secondary outcomes included the differences in pruritus, Dermatology Life Quality Index (DLQI), and Eczema Area and Severity Index (EASI) scores between the baseline visit and end-ofstudy visit for each cohort.ResultsThe group receiving apremilast, 20 mg twice daily, displayed a significant reduction from baseline of pruritus (P=.02) and the DLQI (P=.003) at 3 months. The group receiving apremilast, 30 mg twice daily, displayed a significant reduction of the EASI (P=.008) and the DLQI (P=.01) at 3 months. At 6 months, there was a significant reduction of the EASI (P=.002), the visual analog scale (P=.03), and the DLQI (P=.03). Gene ontologic analyses comparing baseline with samples during treatment revealed alterations in immune response pathways, especially those related to cyclic adenosine monophosphate–mediated signaling.ConclusionsThese results support further development of apremilast for treatment of atopic dermatitis. Larger randomized controlled studies are needed to more adequately evaluate both safety and efficacy. Limitations include the small sample size and absence of a control.Trial registrationclinicaltrials.gov Identifier: NCT01393158.
| S-EPMC3614494 | biostudies-literature
Project description:Atopic dermatitis (AD) is a chronic and relapsing disease affecting an increasing number of patients. Usually starting in early childhood, AD can be the initial step of the so-called atopic march, i.e. followed by allergic rhinitis and allergic asthma. AD is a paradigmatic genetically complex disease involving gene-gene and gene-environment interactions. Genetic linkage analysis as well as association studies have identified several candidate genes linked to either the epidermal barrier function or to the immune system. Stress, bacterial or viral infections, the exposure to aero- or food-allergens as well as hygienic factors are discussed to aggravate symptoms of AD. Athough generalized Th2-deviated immune response is closely linked to the condition of AD, the skin disease itself is a biphasic inflammation with an initial Th2 phase and while chronic lesions harbour Th0/Th1 cells. Regulatory T cells have been shown to be altered in AD as well as the innate immune system in the skin. The main treatment-goals include the elimination of inflammation and infection, preserving and restoring the barrier function and controlling exacerbating factors. The overall future strategy in AD will be aimed to control skin inflammation by a more proactive management in order to potentially prevent the emergence of sensitization as well as to design customized management based on genetic and pathophysiologic information.
| S-EPMC2883413 | biostudies-literature
Project description:BackgroundNumerous therapies have recently emerged for treatment of patients with atopic dermatitis (AD), a common skin disease, and understanding their cost-effectiveness is of high importance for policy makers. This systematic literature review (SLR) aimed to provide an overview of full economic evaluations that assessed cost-effectiveness of emerging AD treatments.MethodsThe SLR was conducted in Medline, Embase, UK National Health Service Economic Evaluation Database and EconLit. Reports published by the National Institute for Health and Care Excellence, the Institute for Clinical and Economic Review and the Canadian Agency for Drugs and Technologies in Health were manually searched. Economic evaluations published from 2017 to September 2022 that compared emerging AD treatments with any comparator were included. Quality assessment was conducted by using the Consensus on Health Economic Criteria list.ResultsA total of 1333 references were screened after removing duplicates. Among those references, 15 that conducted a total of 24 comparisons were included. Most studies were from the USA, UK or Canada. Seven different emerging treatments were compared, mostly with usual care. In 15 comparisons (63%), the emerging treatment was cost-effective, and 11 out of 14 dupilumab comparisons (79%) reported that dupilumab was cost-effective. Upadacitinib was the only emerging therapy that was never classified as cost-effective. On average, 13 out of 19 quality criteria (68%) per reference were rated as fulfilled while manuscripts and health technology reports received generally higher quality assessment scores than published abstracts.DiscussionThis study revealed some discrepancies in the cost-effectiveness of emerging therapies for AD. A variety of designs and guidelines made comparison difficult. Therefore, we recommend that future economic evaluations use more similar modelling approaches to improve comparability of results.OthersThe protocol was published in PROSPERO (ID: CRD42022343993).
| S-EPMC10570180 | biostudies-literature
Project description:Keratinocytes from healthy donors stimulated with type 2 cytokines are often used to experimentally study atopic dermatitis (AD) inflammatory responses. Due to potential intrinsic alterations, it seems favorable to use keratinocytes from AD patients. Keratinocytes isolated from hair follicles offer a non-invasive approach to investigate AD-derived keratinocytes. To evaluate whether such AD-derived keratinocytes are suitable to mimic AD inflammatory responses we compared hair follicle-derived keratinocytes from healthy donors and AD patients in a type 2 cytokine environment. Stimulation of AD-derived keratinocytes with IL-4 and IL-13 induced higher expression changes of AD-associated markers as compared to healthy keratinocytes. The combination of IL-4 and IL-13 generally induced highest expression changes, but IL-13 alone also induced significant changes of AD-specific markers. Similar to the 2D cultures, IL-4/IL-13 stimulation of 3D skin models generated with AD-derived keratinocytes modulated the expression of several AD-relevant factors. Whole transcriptome analysis revealed that IL-4 and IL-13 acted similarly on these 3D skin models. Histologically, IL-13 alone and in combination with IL-4 increased epidermal spongiosis, a histological hallmark of AD skin. Taken together, our pilot study suggests that hair follicle-derived keratinocytes from AD patients represent a useful model system to study AD-related inflammation in a personalized in vitro model.
2024-08-19 | GSE243634 | GEO