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Effects of structured patient education in adult atopic dermatitis - multi-center randomized controlled trial.

Research paper by Annice A Heratizadeh, Thomas T Werfel, Andreas A Wollenberg, Susanne S Abraham, Sibylle S Plank-Habibi, Christina C Schnopp, Michael M Sticherling, Christian C Apfelbacher, Tilo T Biedermann, Kristine K Breuer, Isabel I Fell, Regina R Fölster-Holst, Guido G Heine, Jennifer J Grimm, Lars L Hennighausen, et al.

Indexed on: 01 Mar '17Published on: 01 Mar '17Published in: Journal of Allergy and Clinical Immunology



Abstract

Atopic dermatitis (AD) is a chronic relapsing skin disease prevalent in 1-3% of adults in Western industrialized countries.To investigate the effectiveness of educational training in an outpatient setting on coping with the disease, quality of life (QoL), symptoms and severity in adults with AD.In this German prospective, randomized controlled multi-center study, adult patients with moderate to severe AD were educated by referring to a comprehensive 12 hour training manual consented by a multi-professional study group from different centers ("ARNE=Arbeitsgemeinschaft Neurodermitisschulung für Erwachsene"). Patients were randomly allocated to the intervention group or "waiting control group". Study visits were performed at baseline and after one year (1-year follow-up). Primary outcomes were defined as a decrease of (1) "catastrophizing cognitions" with respect to itching (JKF questionnaire), (2) "social anxiety" (MHF questionnaire), (3) subjective burden by symptoms of the disease (Skindex-29 questionnaire) and (4) improvement of disease signs and symptoms assessed by scoring atopic dermatitis (SCORAD) index at 1-year follow-up. Data was analyzed by intention-to-treat.At 1-year follow-up patients from the intervention group (n=168) showed a significantly better improvement compared to the waiting group (n=147) in the following defined primary study outcomes: coping behavior with respect to itching [P<.001]; QoL assessed by Skindex-29 questionnaire [P<.001] and SCORAD index [P<.001].This is the first randomized, controlled multi-center study on patient education in adulthood AD. The ARNE training program shows significant beneficial effects on a variety of psychosocial parameters as well as on AD severity.