Age related, structured educational programmes for the management of atopic dermatitis in children and adolescents: Multicentre, randomised controlled trial

Objective: To determine the effects of age related, structured educational programmes on the management of moderate to severe atopic dermatitis in childhood and adolescence. Design: Multicentre, randomised controlled trial. Setting: Seven hospitals in Germany. Participants: Parents of children with atopic dermatitis aged 3 months to 7 years (n=274) and 8-12 years (n=102), adolescents with atopic dermatitis aged 13-18 years (n=70), and controls (n=244, n=83, and n=50, respectively). Interventions: Group sessions of standardised intervention programmes for atopic dermatitis once weekly for six weeks or no education (control group). Main outcome measures: Severity of eczema (scoring of atopic dermatitis scale), subjective severity (standardised questionnaires), and quality of life for parents of affected children aged less than 13 years, over 12 months. Results: Significant improvements in severity of eczema and subjective severity were seen in all intervention groups compared with control groups (total score for severity: age 3 months to 7 years - 17.5, 95% confidence intervals - 19.6 to - 15.3 v - 12.2, - 14.3 to - 10.1; age 8-12 years -16.0, - 20.0 to - 12.0 v - 7.8, - 11.4; - 4.3; and age 13-18 years - 19.7, - 23.7 to - 15.7 v - 5.2, - 10.5 to 0.1). Parents of affected children aged less than 7 years experienced significantly better improvement in all five quality of life subscales, whereas parents of affected children aged 8-12 years experienced significantly better improvement in three of five quality of life subscales. Conclusion: Age related educational programmes for the control of atopic dermatitis in children and adolescents are effective in the long term management of the disease.