Effects of structured patient education in adults with atopic dermatitis: Multicenter randomized controlled trial
Effects of structured patient education in adults with atopic dermatitis: Multicenter randomized controlled trial
复制标题
DOI：
10.1016/j.jaci.2017.01.029
复制
发表时间：
2017-09-01
影响因子：
14.2
通讯作者：
Kupfer, Joerg
中科院分区：
文献类型：
--
作者：
Heratizadeh, Annice;Werfel, Thomas;Kupfer, Joerg
背景资料：特应性皮炎（AD）是一种慢性复发性皮肤病，在西方工业化国家的成人中流行率为1%至3%。目的：我们试图调查门诊教育培训对AD患者应对疾病、生活质量、症状和严重程度的有效性。方法：在这项德国前瞻性随机对照多中心研究中，成人中重度AD患者通过参考全面的12-小时培训手册，由来自不同中心的多专业研究小组（Arbeitsgemeinschaft Neurodermitisschulung fur Erwachelor [阿恩]）同意。患者被随机分配到干预组或等待对照组。在基线和1年后（1年随访）进行研究访视。主要结局定义为（1）瘙痒方面的"灾难性认知"（Juckreiz-Kognitions-Fragebogen问卷）、（2）"社交焦虑"（Marburger Hautfragebogen问卷）、（3）疾病症状的主观负担（Skindex-29问卷）和（4）1年随访时使用SCORAD指数评估的疾病体征和症状改善。数据进行了分析的意向治疗的basis.Results：在1年的随访中，患者从干预组（n = 168）表现出显着更好的改善相比，等待组（n = 147）在以下定义的主要研究成果：瘙痒应对行为（P <.001），使用Skindex-29问卷评估生活质量结论：这是第一个关于成人AD患者教育的随机、对照、多中心研究。阿恩训练计划显示出对各种心理社会参数以及AD严重程度的显著有益效果。
Background: Atopic dermatitis (AD) is a chronic relapsing skin disease prevalent in 1% to 3% of adults in Western industrialized countries.Objective: We sought to investigate the effectiveness of educational training in an outpatient setting on coping with the disease, quality of life, symptoms, and severity in adults with AD.Methods: In this German prospective, randomized controlled multicenter study, adult patients with moderate-to-severe AD were educated by referring to a comprehensive 12-hour training manual consented by a multiprofessional study group from different centers (Arbeitsgemeinschaft Neurodermitisschulung fur Erwachsene [ARNE]). Patients were randomly allocated to the intervention or waiting control groups. Study visits were performed at baseline and after 1 year (1 year of follow-up). Primary outcomes were defined as a decrease in (1) "catastrophizing cognitions'' with respect to itching (Juckreiz-Kognitions-Fragebogen questionnaire), (2) "social anxiety'' (Marburger Hautfragebogen questionnaire), (3) subjective burden by symptoms of the disease (Skindex-29 questionnaire), and (4) improvement of disease signs and symptoms assessed by using the SCORAD index at 1 year of follow-up. Data were analyzed on an intention-to-treat basis.Results: At 1 year of follow-up, patients from the intervention group (n = 168) showed a significantly better improvement compared with the waiting group (n = 147) in the following defined primary study outcomes: coping behavior with respect to itching (P < .001), quality of life assessed by using the Skindex-29 questionnaire (P < .001), and the SCORAD index (P < .001).Conclusions: This is the first randomized, controlled multicenter study on patient education in adult AD. The ARNE training program shows significant beneficial effects on a variety of psychosocial parameters, as well as AD severity.