Physician-authored summaries and commentary on the most important medical research, provided by the NEJM Group, a division of the Massachusetts Medical Society.
© Massachusetts Medical SocietyJanuary/February 2023
Online programs were modestly effective for children and young adults.
Eczema treatment guidelines stress the importance of patient education. In-person educational programs can be costly and inconvenient for patients and are not widely available, and only limited evidence suggests they improve eczema outcomes. Online interventions might be more accessible and scalable but have not been assessed in large randomised trials.
Researchers conducted parallel studies of two online self-management educational programs, one for parents or caregivers of children (age, 12 years and younger) with mild to severe eczema and the other for young people (age range, 13 to 25 years) with mild to severe eczema. In each study, about 300 caregivers or patients recruited from primary care practices in the UK were randomised to usual care alone or usual care plus the online intervention. The studies were conducted entirely online, including registration, consent, intervention and collection of baseline and outcome data.
After 24 weeks, intervention recipients in both studies reported slightly but significantly greater improvement in symptom scores than controls (mean difference, 1.5 to 1.9 points on a 28 point scale). Participants in the intervention groups were about twice as likely as those in the control groups to report a ‘minimum clinically important’ improvement of 2.5 points, with a number needed to treat of six. The differences were largely sustained after 52 weeks.
Comment: Although this trial showed only a modest treatment effect, it suggests that inexpensive online behavioural interventions for eczema can provide some benefit. This program is accessible at https://www.EczemaCareOnline.org.uk.
BRUCE SOLOWAY, MD
Associate Professor Emeritus of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
Santer M, et al. Eczema Care Online behavioural interventions to support self- care for children and young people: two independent, pragmatic, randomised controlled trials. BMJ 2022; 379: e072007.
This summary is taken from the following Journal Watch title: Pediatrics and Adolescent Medicine