Where and how have written action plans for atopic eczema/dermatitis been developed and evaluated?: Systematic review

Charankumal Thandi; Sophie Constantinuo; Rosie C Vincent; Matthew J Ridd

doi:10.1002/ski2.213

Where and how have written action plans for atopic eczema/dermatitis been developed and evaluated? Systematic review

Charankumal Thandi^*
, Sophie Constantinuo
, Rosie C Vincent
, Matthew J Ridd

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

4 Citations (Scopus)

54 Downloads (Pure)

Abstract

Abstract
Background
Atopic eczema/dermatitis is a common inflammatory condition which affects 15%–30% of children and 2%–10% of adults. It can have a significant impact and its management can be challenging. It is important for patients, parents, and caregivers to know how to look after their skin.

Objectives
To identify and review written eczema action plans (WAPs) that are available internationally for use by patients, parents, and caregivers.

Methods
We followed Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines. We searched relevant databases (MEDLINE, Embase, COCHRANE) from inception until March 2022. We sought grey literature via Google searches and professional networks. Database search results were independently reviewed by two different reviewers. With identified WAPs, we assessed length, appearance, content, how it was developed and whether it had been evaluated.

Results
From 312 abstracts, supplemented by other searches, we identified 20 unique eczema WAPs. From nine countries, all were written in English with 18 were designed for children. For the majority, it was unclear whether any development work preceded their creation or the intended clinical setting for use. Nineteen had a stepwise approach, 17 advised when to seek help, 6 were visually appealing and 6 had a rationale behind treatment documented in the WAP. Only three had been evaluated in clinical trials.

Conclusion
Further evaluation is needed to assess the effectiveness of the WAPs that currently exist, prior to creating further WAPs. Patient and caregiver involvement is needed in any future work.

Original language	English
Article number	e213
Journal	Skin Health and Disease
Volume	3
Issue number	3
Early online date	22 Mar 2023
DOIs	https://doi.org/10.1002/ski2.213
Publication status	Published - 31 May 2023

Bibliographical note

Funding Information:
The authors would like to acknowledge Sarah Herring, Subject Librarian for Biochemistry, Population Health Sciences (Bristol Medical School) and Psychological Science, University of Bristol for her help with developing and running the literature searches; and Magali Reeding, former Chief Operating Officer for Eczema Outreach Support, for her patient perspective on WAPs. CST is funded by a National Institute for Health Research (NIHR) Academic Clinical Fellowship (ACF) in Dermatology. The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the NIHR or Department of Health.

Funding Information:
The authors would like to acknowledge Sarah Herring, Subject Librarian for Biochemistry, Population Health Sciences (Bristol Medical School) and Psychological Science, University of Bristol for her help with developing and running the literature searches; and Magali Reeding, former Chief Operating Officer for Eczema Outreach Support, for her patient perspective on WAPs. CST is funded by a National Institute for Health Research (NIHR) Academic Clinical Fellowship (ACF) in Dermatology. The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the NIHR or Department of Health.

Publisher Copyright:
© 2023 The Authors. Skin Health and Disease published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

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Cite this

@article{03ed0f477dde493abdd06279af42dc7d,

title = "Where and how have written action plans for atopic eczema/dermatitis been developed and evaluated?: Systematic review",

abstract = "Abstract Background Atopic eczema/dermatitis is a common inflammatory condition which affects 15\%–30\% of children and 2\%–10\% of adults. It can have a significant impact and its management can be challenging. It is important for patients, parents, and caregivers to know how to look after their skin. Objectives To identify and review written eczema action plans (WAPs) that are available internationally for use by patients, parents, and caregivers. Methods We followed Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines. We searched relevant databases (MEDLINE, Embase, COCHRANE) from inception until March 2022. We sought grey literature via Google searches and professional networks. Database search results were independently reviewed by two different reviewers. With identified WAPs, we assessed length, appearance, content, how it was developed and whether it had been evaluated. Results From 312 abstracts, supplemented by other searches, we identified 20 unique eczema WAPs. From nine countries, all were written in English with 18 were designed for children. For the majority, it was unclear whether any development work preceded their creation or the intended clinical setting for use. Nineteen had a stepwise approach, 17 advised when to seek help, 6 were visually appealing and 6 had a rationale behind treatment documented in the WAP. Only three had been evaluated in clinical trials. Conclusion Further evaluation is needed to assess the effectiveness of the WAPs that currently exist, prior to creating further WAPs. Patient and caregiver involvement is needed in any future work.",

author = "Charankumal Thandi and Sophie Constantinuo and Vincent, \{Rosie C\} and Ridd, \{Matthew J\}",

note = "Funding Information: The authors would like to acknowledge Sarah Herring, Subject Librarian for Biochemistry, Population Health Sciences (Bristol Medical School) and Psychological Science, University of Bristol for her help with developing and running the literature searches; and Magali Reeding, former Chief Operating Officer for Eczema Outreach Support, for her patient perspective on WAPs. CST is funded by a National Institute for Health Research (NIHR) Academic Clinical Fellowship (ACF) in Dermatology. The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the NIHR or Department of Health. Funding Information: The authors would like to acknowledge Sarah Herring, Subject Librarian for Biochemistry, Population Health Sciences (Bristol Medical School) and Psychological Science, University of Bristol for her help with developing and running the literature searches; and Magali Reeding, former Chief Operating Officer for Eczema Outreach Support, for her patient perspective on WAPs. CST is funded by a National Institute for Health Research (NIHR) Academic Clinical Fellowship (ACF) in Dermatology. The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the NIHR or Department of Health. Publisher Copyright: {\textcopyright} 2023 The Authors. Skin Health and Disease published by John Wiley \& Sons Ltd on behalf of British Association of Dermatologists.",

year = "2023",

month = may,

day = "31",

doi = "10.1002/ski2.213",

language = "English",

volume = "3",

journal = "Skin Health and Disease",

issn = "2690-442X",

publisher = "John Wiley \& Sons, Ltd.",

number = "3",

}

TY - JOUR

T1 - Where and how have written action plans for atopic eczema/dermatitis been developed and evaluated?

T2 - Systematic review

AU - Thandi, Charankumal

AU - Constantinuo, Sophie

AU - Vincent, Rosie C

AU - Ridd, Matthew J

N1 - Funding Information: The authors would like to acknowledge Sarah Herring, Subject Librarian for Biochemistry, Population Health Sciences (Bristol Medical School) and Psychological Science, University of Bristol for her help with developing and running the literature searches; and Magali Reeding, former Chief Operating Officer for Eczema Outreach Support, for her patient perspective on WAPs. CST is funded by a National Institute for Health Research (NIHR) Academic Clinical Fellowship (ACF) in Dermatology. The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the NIHR or Department of Health. Funding Information: The authors would like to acknowledge Sarah Herring, Subject Librarian for Biochemistry, Population Health Sciences (Bristol Medical School) and Psychological Science, University of Bristol for her help with developing and running the literature searches; and Magali Reeding, former Chief Operating Officer for Eczema Outreach Support, for her patient perspective on WAPs. CST is funded by a National Institute for Health Research (NIHR) Academic Clinical Fellowship (ACF) in Dermatology. The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the NIHR or Department of Health. Publisher Copyright: © 2023 The Authors. Skin Health and Disease published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

PY - 2023/5/31

Y1 - 2023/5/31

N2 - Abstract Background Atopic eczema/dermatitis is a common inflammatory condition which affects 15%–30% of children and 2%–10% of adults. It can have a significant impact and its management can be challenging. It is important for patients, parents, and caregivers to know how to look after their skin. Objectives To identify and review written eczema action plans (WAPs) that are available internationally for use by patients, parents, and caregivers. Methods We followed Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines. We searched relevant databases (MEDLINE, Embase, COCHRANE) from inception until March 2022. We sought grey literature via Google searches and professional networks. Database search results were independently reviewed by two different reviewers. With identified WAPs, we assessed length, appearance, content, how it was developed and whether it had been evaluated. Results From 312 abstracts, supplemented by other searches, we identified 20 unique eczema WAPs. From nine countries, all were written in English with 18 were designed for children. For the majority, it was unclear whether any development work preceded their creation or the intended clinical setting for use. Nineteen had a stepwise approach, 17 advised when to seek help, 6 were visually appealing and 6 had a rationale behind treatment documented in the WAP. Only three had been evaluated in clinical trials. Conclusion Further evaluation is needed to assess the effectiveness of the WAPs that currently exist, prior to creating further WAPs. Patient and caregiver involvement is needed in any future work.

AB - Abstract Background Atopic eczema/dermatitis is a common inflammatory condition which affects 15%–30% of children and 2%–10% of adults. It can have a significant impact and its management can be challenging. It is important for patients, parents, and caregivers to know how to look after their skin. Objectives To identify and review written eczema action plans (WAPs) that are available internationally for use by patients, parents, and caregivers. Methods We followed Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines. We searched relevant databases (MEDLINE, Embase, COCHRANE) from inception until March 2022. We sought grey literature via Google searches and professional networks. Database search results were independently reviewed by two different reviewers. With identified WAPs, we assessed length, appearance, content, how it was developed and whether it had been evaluated. Results From 312 abstracts, supplemented by other searches, we identified 20 unique eczema WAPs. From nine countries, all were written in English with 18 were designed for children. For the majority, it was unclear whether any development work preceded their creation or the intended clinical setting for use. Nineteen had a stepwise approach, 17 advised when to seek help, 6 were visually appealing and 6 had a rationale behind treatment documented in the WAP. Only three had been evaluated in clinical trials. Conclusion Further evaluation is needed to assess the effectiveness of the WAPs that currently exist, prior to creating further WAPs. Patient and caregiver involvement is needed in any future work.

U2 - 10.1002/ski2.213

DO - 10.1002/ski2.213

M3 - Article (Academic Journal)

C2 - 37275422

SN - 2690-442X

VL - 3

JO - Skin Health and Disease

JF - Skin Health and Disease

IS - 3

M1 - e213

ER -