Effects of structured patient education in adults with atopic dermatitis: Multicenter randomized controlled trial

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Annice Heratizadeh - , Hannover Medical School (MHH) (Author)
  • Thomas Werfel - , Hannover Medical School (MHH) (Author)
  • Andreas Wollenberg - , Ludwig Maximilian University of Munich (Author)
  • Susanne Abraham - , Department of Dermatology (Author)
  • Sibylle Plank-Habibi - , Vital Klinik GmbH & Co. KG (Author)
  • Christina Schnopp - , Technical University of Munich (Author)
  • Michael Sticherling - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Christian Apfelbacher - , Heidelberg University , University of Regensburg (Author)
  • Tilo Biedermann - , Technical University of Munich, University of Tübingen (Author)
  • Kristine Breuer - , Dermatologikum Hamburg (Author)
  • Isabel Fell - , Hautmedizin Bad Soden (Author)
  • Regina Fölster-Holst - , University Hospital Schleswig-Holstein Campus Kiel (Author)
  • Guido Heine - , Charité – Universitätsmedizin Berlin (Author)
  • Jennifer Grimm - , Dermatologisches Zentrum Buxtehude (Author)
  • Lars Hennighausen - , Psychological Practice (Author)
  • Claudia Kugler - , Technical University of Munich (Author)
  • Imke Reese - , Nutrition Counselling Allergology (Author)
  • Johannes Ring - , Technical University of Munich, Christine Kühne-Center for Allergy Research and Education (CK-CARE) (Author)
  • Knut Schäkel - , Heidelberg University  (Author)
  • Jochen Schmitt - , Center for Evidence-Based Healthcare (Author)
  • Kurt Seikowski - , Leipzig University (Author)
  • Esther von Stebut - , Johannes Gutenberg University Mainz (Author)
  • Nicola Wagner - , Heidelberg University  (Author)
  • Anja Waßmann-Otto - , Hannover Medical School (MHH) (Author)
  • Ute Wienke-Graul - , Vital Klinik GmbH & Co. KG (Author)
  • Elke Weisshaar - , Heidelberg University  (Author)
  • Margitta Worm - , Charité – Universitätsmedizin Berlin (Author)
  • Uwe Gieler - , Justus Liebig University Giessen (Author)
  • Joerg Kupfer - , Justus Liebig University Giessen (Author)
  • Katrin Brauner - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Sabine Dölle - , Charité – Universitätsmedizin Berlin (Author)
  • Laura Ehmann - , Ludwig Maximilian University of Munich (Author)
  • Ute Hagmaier - , Heidelberg University  (Author)
  • Susanne Eberlein - , Vital Klinik GmbH & Co. KG (Author)
  • Julia Kroth - , Ludwig Maximilian University of Munich (Author)
  • Katja Lämmerhirt - , Department of Dermatology (Author)
  • Rosemarie Landleiter - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Ute Lorenz - , Vital Klinik GmbH & Co. KG (Author)
  • Anja Lüdemann - , Department of Dermatology (Author)
  • Uwe Matterne - , Heidelberg University  (Author)
  • Heidrun Mitzel-Rink - , Johannes Gutenberg University Mainz (Author)
  • Margarete Niebuhr - , Hannover Medical School (MHH) (Author)
  • Tessa Rehberg - , Medical Faculty Carl Gustav Carus (Author)
  • Sandra Vogel - , Ludwig Maximilian University of Munich (Author)
  • Katja Wichmann - , Hannover Medical School (MHH) (Author)

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.

Details

Original languageEnglish
Pages (from-to)845-853.e3
JournalJournal of allergy and clinical immunology
Volume140
Issue number3
Publication statusPublished - Sept 2017
Peer-reviewedYes

External IDs

PubMed 28242304
ORCID /0000-0001-7457-6481/work/166764109

Keywords

ASJC Scopus subject areas

Keywords

  • adulthood, Atopic dermatitis, coping, disease severity, multi-professional, patient education, psychosocial, quality of life