A Multimodal Education and Treatment Program for Young Adults with Atopic Dermatitis: A Randomized Controlled Trial

Abstract

Background: Atopic dermatitis (AD) is a chronic skin disorder with multifactorial etiology and with high medical, psychological, social, and financial impact. The aim of treatment is coping with this disease rather than cure. Adequate coping implies knowledge of the multifactorial etiology including psychological factors, compliance with dermatological treatment, and adjustment to the consequences of this chronic condition in daily life. Education and training should improve self-management and reduce dependency on medical consultation. Objective: To describe and evaluate a multimodal, psychoeducational and dermatological treatment program for young adults with atopic dermatitis. Methods: A multimodal treatment program was developed: a 2-week intensive multidisciplinary education and training program for small groups. Patients aged 18–35 years with moderate to severe AD (SCORAD > 20) were randomly assigned to the treatment program group (n = 31) and a control group (n = 22); 2 patients of the control group dropped out. Baseline assessment took place before treatment. Short-term effects were measured after 10 weeks, long-term effects after 40 weeks. Patients in the control group received standard care. Primary outcome measures were: the total score on the Marburg AD questionnaire, sick leave, and medical consultations. Secondary outcome measures were: quality of life (SF-36), appraisal of self-care, use of emollients, and SCORAD. Results: The experimental group scored significantly better on the Marburg AD questionnaire after treatment (short term and long term). At follow-up after 40 weeks, the experimental group scored better on appraisal of self-care, needed less time for medical consultations, and used more emollients without steroids. Sick leave was less after 10 weeks, but equalized at follow-up. Patient satisfaction with the multimodal treatment program was high. Conclusions: The results of this pilot study suggest that the treatment program is successful in improving self-management of patients; they perceive more control over their chronic disease, and interactions with their doctors are more efficient and more satisfying for both patients and doctors.