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Research

Age related, structured educational programmes for the management of atopic dermatitis in children and adolescents: multicentre, randomised controlled trial

BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7547.933 (Published 20 April 2006) Cite this as: BMJ 2006;332:933
  1. Doris Staab, paediatric allergologist1,
  2. Thomas L Diepgen, professor (thomas_diepgen{at}med.uni-heidelberg.de),
  3. Manigé Fartasch, professor3,
  4. Jörg Kupfer, psychologis4,
  5. Thomas Lob-Corzilius, paediatric allergologist5,
  6. Johannes Ring, professor6,
  7. Sibylle Scheewe, paediatric allergologist7,
  8. Reginald Scheidt, epidemiologist2,
  9. Gerhard Schmid-Ott, professor8,
  10. Christina Schnopp, dermatologist6,
  11. Rüdiger Szczepanski, paediatric allergologist5,
  12. Thomas Werfel, professor9,
  13. Marita Wittenmeier, atopic dermatitis trainer10,
  14. Ulrich Wahn, professor1,
  15. Uwe Gieler, professor11
  1. 1 Department of Paediatric Pulmonology and Immunology, Charité, Humboldt University, Berlin
  2. 2 Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Thibautstrasse 3, D-69115 Heidelberg, Germany
  3. 3 Department of Dermatology, University Erlangen, Germany
  4. 4 Department for Medical Psychology, Justus-Liebig-University Giessen, Germany
  5. 5 Childrens Hospital Osnabrück, Germany
  6. 6 Department of Dermatology and Allergy Biederstein, Technical University Munich, Germany
  7. 7 Rehabilitation Clinic for Children and Adolescents, Sylt, Germany
  8. 8 Department of Psychosomatic Medicine, Hannover Medical School, Germany
  9. 9 Department of Dermatology and Allergology, Hannover Medical School, Germany
  10. 10 Childrens' Hospital Amsterdamer Strasse, Köln, Germany
  11. 11 Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig-University Giessen, Germany
  1. Correspondence to: T L Diepgen
  • Accepted 9 March 2006

Abstract

Objective To determine the effects of age related, structured educational programmes on the management of moderate to severe atopic dermatitis in childhood and adolescence.

Design Multicentre, randomised controlled trial.

Setting Seven hospitals in Germany.

Participants Parents of children with atopic dermatitis aged 3 months to 7 years (n = 274) and 8-12 years (n = 102), adolescents with atopic dermatitis aged 13-18 years (n = 70), and controls (n = 244, n = 83, and n = 50, respectively).

Interventions Group sessions of standardised intervention programmes for atopic dermatitis once weekly for six weeks or no education (control group).

Main outcome measures Severity of eczema (scoring of atopic dermatitis scale), subjective severity (standardised questionnaires), and quality of life for parents of affected children aged less than 13 years, over 12 months.

Results Significant improvements in severity of eczema and subjective severity were seen in all intervention groups compared with control groups (total score for severity: age 3 months to 7 years - 17.5, 95% confidence intervals - 19.6 to - 15.3 v - 12.2, - 14.3 to - 10.1; age 8-12 years - 16.0, - 20.0 to - 12.0 v - 7.8, - 11.4; - 4.3; and age 13-18 years - 19.7, - 23.7 to - 15.7 v - 5.2, - 10.5 to 0.1). Parents of affected children aged less than 7 years experienced significantly better improvement in all five quality of life subscales, whereas parents of affected children aged 8-12 years experienced significantly better improvement in three of five quality of life subscales.

Conclusion Age related educational programmes for the control of atopic dermatitis in children and adolescents are effective in the long term management of the disease.

Footnotes

  • Embedded ImageStudy centres and members are on bmj.com

  • Contributors DS was study coordinator. She was responsible for the educational programme in one of the study centres and was involved in the study design, evaluation of the instruments, and development of the programme. TLD was responsible for the evaluation centre and data management, was involved in the study design, evaluation of the instruments, and the development of the medical content of the programme, and wrote the paper with UG and DS. MF was responsible for one of the study centres and was involved in the development of the medical content of the programme. JK was involved in the development and testing of the evaluation instruments. TL-C was involved in the development of the child educational part of the programme. JR was responsible for one of the study centres and was involved in the development of the medical content of the programme. SS was responsible for the inpatient study centre and was mainly involved in the development of the adolescent part of the programme and didactic topics. RS was involved in the study design, data management, and evaluation. GS-O was involved in the development of the psychological content of the programme and in the evaluation. CS was responsible for the educational programme in one of the study centres and was involved in the development of the medical content of the programme. RSch was responsible for one of the study centres and was involved in the development of the medical content of the programme. TW was responsible for one of the study centres and was involved in the development of the medical content of the programme and the didactic presentation of the manuals. MW was responsible for the educational programme in one of the study centres and was involved in the didactic development of the programme. UW was principal investigator, initiated the proposal and was involved in the study design. UG was involved in the study design and was head of the evaluation group. All authors approved the final draft. DS, TLD, MF, JR, RSch, TW, and UG are guarantors.

  • Funding German Federal Ministry of Health and Social Services (grant No 01GL0010).

  • Competing interests None declared.

  • Ethical approval Ethics committee of the Humboldt University, Berlin.

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