Atopic dermatitis: Recommendations for educational interventions

  • Educational programs (i.e., training programs and ‘‘eczema schools’’) are recommended as an adjunct to the conventional therapy of atopic dermatitis.

Level of Evidence: I  Strength of Recommendation: A

  • Video interventions can be recommended as an adjunct to conventional therapy.
  • Eczema workshops and nurse-led programs may be useful as an adjunct to conventional therapy.

Level of Evidence: II  Strength of Recommendations: B 


Read more about these recommendations 

The education of patients and caregivers is itself an important form of intervention.  Because AD has a complex pathogenesis and involves multiple (and sometimes rotating) therapies, it inherently requires much teaching and support to achieve and maintain good response. Increased knowledge of disease mechanisms and course, the appropriate use of therapies, and the goals of management can improve treatment adherence and lessen fears and misconceptions.27 Educational methods vary greatly in scope, intensity, frequency, setting, and personnel used. Disease directed teaching can be on an individual or group basis. 

Formal, structured multidisciplinary educational programs (ie, training programs or ‘‘eczema schools’’) for children and adults have already been established in some countries.28-31 The largest RCT to date involved 823 German children and adolescents with moderate to severe AD and their families. A 6-week educational program consisting of once-weekly, 2-hour sessions led by a team having dermatologic, nutritional, and psychological components resulted in decreased disease severity as measured by the SCORing Atopic Dermatitis (SCORAD) index, relative to the control group.30 There have also been significant improvements in subjective assessments of severity, itching behavior, and ability to cope in groups receiving structured education.30,32,33 Increased adaptive use of medication based on AD severity has also been shown.33 Such formal training programs have the strongest supportive evidence but do require significant personnel and financial resources. Comparison between programs is difficult because the content is heterogeneous and outcome measures vary greatly between studies.34

Navigate section 4 of the AD guideline: Disease flares and adjunctive therapy  

Citation note

When referencing this guideline in a publication, please use the following citation: Sidbury R, Tom WL, Bergman JN, Cooper KD, Silverman RA, Berger TG, et al. Guidelines of care for the management of atopic dermatitis: Section 4. Prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol. 2014 Dec;71(6):1218-33.

 


View the AAD guidelines disclaimer.