Education to improve quality of life of people with chronic inflammatory skin conditions: a systematic review of the evidence

Summary Patient and carer education has been proposed as a way of improving health‐related quality of life (HRQoL) among people with chronic inflammatory skin conditions. This systematic review aimed to assess the effects of education that specifically addresses HRQoL among people with chronic infla...

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Bibliographic Details
Published in:British journal of dermatology (1951) 2016-06, Vol.174 (6), p.1228-1241
Main Authors: Pickett, K., Frampton, G., Loveman, E.
Format: Article
Language:English
Subjects:
Acne
Adolescent
Adult
Atopic dermatitis
Caregivers - education
Child
Child, Preschool
Children
Chronic Disease
Clinical trials
Dermatitis - prevention & control
Eczema
Education
Female
Health Education - methods
Humans
Inflammation
Male
Patient Education as Topic - methods
Psoriasis
Quality of Life
Randomized Controlled Trials as Topic
Skin
Skin diseases
Statistical analysis
Systematic review
Treatment Outcome
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Summary:Summary Patient and carer education has been proposed as a way of improving health‐related quality of life (HRQoL) among people with chronic inflammatory skin conditions. This systematic review aimed to assess the effects of education that specifically addresses HRQoL among people with chronic inflammatory skin conditions. We searched 12 literature databases and other sources (up to July 2014). Seven randomized controlled trials (RCTs) met the review inclusion criteria. Data from these RCTs were extracted and critically appraised. Two RCTs showed that for psoriasis in adults, group‐based and text message education (as adjuncts to usual care) resulted in better HRQoL and disease severity outcomes than comparators, respectively. One RCT found that group‐based education for children with eczema (atopic dermatitis) and their parents resulted in greater improvements in parents’ HRQoL and in the children's disease severity than no education at 12 months. The remaining RCTs evaluated an educational session for psoriasis, a website for carers of children with eczema, information on skincare and make‐up use given to women with acne, and an itch‐coping programme for a range of conditions, all as adjuncts to usual care. None of these RCTs found statistically significant effects on HRQoL or disease severity compared with usual care. Common features of the effective interventions were long delivery (over 6 weeks to 3 months) and delivery by a multidisciplinary team. Overall, the evidence base is currently limited and generally has an unclear risk of bias. There is a need for more large RCTs evaluating piloted and theory‐based interventions. What's already known about this topic? People with chronic inflammatory skin conditions can experience poor health‐related quality of life (HRQoL). There is mixed evidence about whether patient education improves HRQoL. What does this study add? Education often focuses on information about a condition and its treatment. This systematic review examines outcomes of education that specifically aims to improve HRQoL or includes elements that could improve HRQoL. The limited available evidence shows inconsistent HRQoL effects and the need for more theoretically based interventions. Linked Comment: Bundy. Br J Dermatol 2016; 174: 1179. Plain language summary available online
ISSN:0007-0963
1365-2133
DOI:10.1111/bjd.14435