Systematic review of self‐management interventions for people with eczema
Summary Eczema is a common long‐term condition, but inadequate support and information can lead to poor adherence and treatment failure. We have reviewed the international literature of interventions designed to promote self‐management in adults and children with eczema. MEDLINE, MEDLINE in process,...
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| Published in: | British journal of dermatology (1951) 2017-09, Vol.177 (3), p.719-734 |
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| Main Authors: | , , , , |
| Format: | Article |
| Language: | eng |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Summary
Eczema is a common long‐term condition, but inadequate support and information can lead to poor adherence and treatment failure. We have reviewed the international literature of interventions designed to promote self‐management in adults and children with eczema. MEDLINE, MEDLINE in process, Embase, CINAHL and the Global Resource for EczemA Trials database were searched from their inception to August 2016, for randomized controlled trials. Two authors independently applied eligibility criteria, assessed risk of bias for all included studies and extracted data. Twenty studies (3028 participants) conducted in 11 different countries were included. The majority (n = 18) were based in secondary care and most (n = 16) targeted children with eczema. Reporting of studies, including descriptions of the interventions and the outcomes themselves, was generally poor. Thirteen studies were face‐to‐face educational interventions, five were delivered online and two were studies of written action plans. Follow‐up in most studies (n = 12) was short term (up to 12 weeks). Only six trials specified a single primary outcome. There was limited evidence of effectiveness. Only three studies collected and reported outcomes related to cost and just one study undertook any formal cost‐effectiveness analysis. In summary, we have identified a general absence of well‐conducted and well‐reported randomized controlled trials with a strong theoretical basis. Therefore, there is still uncertainty about how best to support self‐management of eczema in a clinically effective and cost‐effective way. Recommendations on design and conduct of future trials are presented.
What's already known about this topic?
Eczema requires a high degree of self‐management by patients.
Adherence to eczema treatments, and hence control of symptoms, can be poor.
There is uncertainty about how best to support self‐management in a clinically effective and cost‐effective way.
What does this study add?
A wide range of interventions designed to promote self‐management have been evaluated in 20 studies across 11 different countries.
Reporting of the design and conduct of these studies is generally poor, and explicit theory describing how interventions are expected to improve care is uncommon.
What works best for people with eczema and whether it is cost‐effective is unknown.
Recommendations for future trials are made.
Linked Comment: Arents. Br J Dermatol 2017; 177:613–614
Plain language summary available onli |
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| ISSN: | 0007-0963 1365-2133 |