Individual therapeutic patient education and consultation in children with atopic dermatitis

Introduction: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease with a prevalence of up to 20% in children. Children with AD and their parents face difficulties related to daily care and management during a relapsing course that may be aggravated by multiple triggers. Recently therapeutic patient education (TPE) and individual consultation have been in use in the treatment of many chronic diseases for optimal management. Therefore, we preliminarily evaluated the necessities of TPE and individual consultation program of therapeutic management in AD. Subjects and Methods: We organized an individually tailored TPE and consultation program provided by multispecialty of allergist, nurse, nutritionist and environmental coordinator. The program is a patient-centered process consisting of informative consultation which addresses the patient’s specific problems including psychosocial support. Enough time was allowed for parents to ask questions during the program. We conducted a questionnaire survey on the disease knowledge before and after the program at the center initially visited. After 3.5 months (min-max: 1-6), participants were contacted by nurses for a telephone interview (TI) with a structured questionnaire (efficiency of the TPE program, symptoms, and quality of life (QOL)). The severity of AD was assessed by allergist using SCORing Atopic Dermatitis (SCORAD). Results: Parents of 135 children with AD took a TPE program and completed the questionnaire survey between May and November 2014. Children with AD were most commonly in the age group of 1~3 years (48, 36%), followed by < 1 age group (36, 27%). The mean SCORAD index of patients was 30.8 (0.0-78.0). The percentages of children with mild, moderate and severe AD were 24, 46, and 30 %, respectively. There was significant improvement in disease awareness by 17.2 from 78.9 to 96.1. Among 135 parents, 100 responded to the questionnaire on the TI. At follow-up TI, 92% answered the TPE program was useful in managing problems related with AD and 86% experienced improvement of the AD symptoms. Furthermore, there was positive change of the QOL in 85% parents. Conclusion: The results of this study demonstrate the usefulness and need of TPE and individual consultation to enable children and their families to care themselves in daily conditions and prevent avoidable complications while improving QOL, ultimately for optimal therapy of AD.