Annice Heratizadeh1, Thomas Werfel2, Andreas Wollenberg3, Susanne Abraham4, Sibylle Plank-Habibi5, Christina Schnopp6, Michael Sticherling7, Christian Apfelbacher8, Tilo Biedermann9, Kristine Breuer10, Isabel Fell11, Regina Fölster-Holst12, Guido Heine13, Jennifer Grimm14, Lars Hennighausen15, Claudia Kugler6, Imke Reese16, Johannes Ring17, Knut Schäkel18, Jochen Schmitt19, Kurt Seikowski20, Esther von Stebut21, Nicola Wagner22, Anja Waßmann-Otto2, Ute Wienke-Graul5, Elke Weisshaar23, Margitta Worm13, Uwe Gieler24, Joerg Kupfer25. 1. Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany. Electronic address: Heratizadeh.Annice@mh-hannover.de. 2. Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany. 3. Department of Dermatology and Allergy, Ludwig-Maximilian-Universität Munich, Munich, Germany. 4. Department of Dermatology, Medical Faculty Carl-Gustav-Carus, Technical University of Dresden, Dresden, Germany. 5. Department of Dermatology and Allergology, Vital Klinik GmbH & Co. KG, Alzenau, Germany. 6. Department of Dermatology and Allergology Biederstein, Technical University Munich, Munich, Germany. 7. Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany. 8. Department of Clinical Social Medicine, University Hospital Heidelberg, Heidelberg, Germany; Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany. 9. Department of Dermatology and Allergology Biederstein, Technical University Munich, Munich, Germany; Department of Dermatology, Eberhard Karls University, Tübingen, Germany. 10. Department of Allergology and Occupational Dermatology, Dermatologikum Hamburg, Hamburg, Germany. 11. Dermatology Centre of Rehabilitation and Prevention GmbH Bad Soden, Bad Soden, Germany. 12. Department of Dermatology, Universitätsklinikum Schleswig-Holstein, Campus Kiel Dermatologie, Venerologie und Allergologie, Kiel, Germany. 13. Department of Dermatology and Allergy, Campus Mitte, Charité Universitätsmedizin, Berlin, Germany. 14. Dermatologisches Zentrum Buxtehude, Buxtehude, Germany. 15. Psychological Practice, Academy of Neurodermatitis Hessen, Hessen, Germany. 16. Nutrition Counselling Allergology, Munich, Germany. 17. Department of Dermatology and Allergology Biederstein, Technical University Munich, Munich, Germany; Christine Kuehne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland. 18. Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany. 19. Center for Evidence-based Healthcare, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Germany. 20. Department of Psychosomatic Medicine, University Leipzig, Leipzig, Germany. 21. Department of Dermatology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany. 22. Klinikum Darmstadt Bereich Eberstadt Hautklinik, Darmstadt, Germany. 23. Department of Clinical Social Medicine, University Hospital Heidelberg, Heidelberg, Germany. 24. Department of Dermatology and Allergology, Justus-Liebig-University Giessen, Giessen, Germany. 25. Institute of Medical Psychology, Justus-Liebig-University Giessen, Giessen, Germany.
Abstract
BACKGROUND: Atopic dermatitis (AD) is a chronic relapsing skin disease prevalent in 1% to 3% of adults in Western industrialized countries. OBJECTIVE: We sought to investigate the effectiveness of educational training in an outpatient setting on coping with the disease, quality of life, symptoms, and severity in adults with AD. METHODS: In this German prospective, randomized controlled multicenter study, adult patients with moderate-to-severe AD were educated by referring to a comprehensive 12-hour training manual consented by a multiprofessional study group from different centers (Arbeitsgemeinschaft Neurodermitisschulung für Erwachsene [ARNE]). Patients were randomly allocated to the intervention or waiting control groups. Study visits were performed at baseline and after 1 year (1 year of follow-up). Primary outcomes were defined as a decrease in (1) "catastrophizing cognitions" with respect to itching (Juckreiz-Kognitions-Fragebogen questionnaire), (2) "social anxiety" (Marburger Hautfragebogen questionnaire), (3) subjective burden by symptoms of the disease (Skindex-29 questionnaire), and (4) improvement of disease signs and symptoms assessed by using the SCORAD index at 1 year of follow-up. Data were analyzed on an intention-to-treat basis. RESULTS: At 1 year of follow-up, patients from the intervention group (n = 168) showed a significantly better improvement compared with the waiting group (n = 147) in the following defined primary study outcomes: coping behavior with respect to itching (P < .001), quality of life assessed by using the Skindex-29 questionnaire (P < .001), and the SCORAD index (P < .001). CONCLUSIONS: This is the first randomized, controlled multicenter study on patient education in adult AD. The ARNE training program shows significant beneficial effects on a variety of psychosocial parameters, as well as AD severity.
RCT Entities:
BACKGROUND:Atopic dermatitis (AD) is a chronic relapsing skin disease prevalent in 1% to 3% of adults in Western industrialized countries. OBJECTIVE: We sought to investigate the effectiveness of educational training in an outpatient setting on coping with the disease, quality of life, symptoms, and severity in adults with AD. METHODS: In this German prospective, randomized controlled multicenter study, adult patients with moderate-to-severe AD were educated by referring to a comprehensive 12-hour training manual consented by a multiprofessional study group from different centers (Arbeitsgemeinschaft Neurodermitisschulung für Erwachsene [ARNE]). Patients were randomly allocated to the intervention or waiting control groups. Study visits were performed at baseline and after 1 year (1 year of follow-up). Primary outcomes were defined as a decrease in (1) "catastrophizing cognitions" with respect to itching (Juckreiz-Kognitions-Fragebogen questionnaire), (2) "social anxiety" (Marburger Hautfragebogen questionnaire), (3) subjective burden by symptoms of the disease (Skindex-29 questionnaire), and (4) improvement of disease signs and symptoms assessed by using the SCORAD index at 1 year of follow-up. Data were analyzed on an intention-to-treat basis. RESULTS: At 1 year of follow-up, patients from the intervention group (n = 168) showed a significantly better improvement compared with the waiting group (n = 147) in the following defined primary study outcomes: coping behavior with respect to itching (P < .001), quality of life assessed by using the Skindex-29 questionnaire (P < .001), and the SCORAD index (P < .001). CONCLUSIONS: This is the first randomized, controlled multicenter study on patient education in adult AD. The ARNE training program shows significant beneficial effects on a variety of psychosocial parameters, as well as AD severity.
Authors: P Schmid-Grendelmeier; R Takaoka; K C Ahogo; W A Belachew; S J Brown; J C Correia; M Correia; B Degboe; V Dorizy-Vuong; O Faye; L C Fuller; K Grando; C Hsu; K Kayitenkore; N Lunjani; F Ly; G Mahamadou; R C F Manuel; M Kebe Dia; E J Masenga; C Muteba Baseke; A N Ouedraogo; F Rapelanoro Rabenja; J Su; J N Teclessou; G Todd; A Taïeb Journal: J Eur Acad Dermatol Venereol Date: 2019-11 Impact factor: 6.166