A Randomized Controlled Trial of an Eczema Care Plan
| Autor: | Maria Jorina, Elena B. Hawryluk, Corinna J. Rea, Larissa M. Wenren, Katherine D. Tran, Sara L. Toomey |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Eczema Documentation Primary care Pediatrics Patient Care Planning law.invention 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Quality of life Adrenal Cortex Hormones law Care plan Humans Medicine 030212 general & internal medicine Child Emollients Primary Health Care business.industry Disease Management Infant Baths Atopic dermatitis Dermatology Life Quality Index medicine.disease Quality Improvement Primary care clinic Test (assessment) Child Preschool Pediatrics Perinatology and Child Health Physical therapy Female business |
| Zdroj: | Academic Pediatrics. 18:789-796 |
| ISSN: | 1876-2859 |
| DOI: | 10.1016/j.acap.2018.02.015 |
| Popis: | To test whether an eczema care plan (ECP) would improve provider documentation and management, decrease eczema severity, and increase patient quality of life (QOL) in the pediatric primary care setting.We conducted a randomized controlled trial from June 2015 to September 2016 at a large hospital-based pediatric primary care clinic. Participants included children from 1 month to 16 years of age with a diagnosis of eczema. The intervention group received the ECP and the control group received usual care. Both groups completed a validated eczema severity scale (Patient-Oriented Eczema Measure [POEM]) and a QOL scale (Infant's Dermatitis Quality of Life Index [IDQOL]) or Children's Dermatology Life Quality Index [CDLQI]) before the visit and again ~1 month later.A total of 211 caregivers completed both the pre- and postintervention surveys (100 control group and 111 intervention group [94% completion]). Intervention group providers were more likely to recommend a comprehensive "step-up" plan (88%) vs 28%; P .001, bleach baths (45%) vs 9%; P .001, and wet wraps (50%) vs 7%; P .001. They were also more likely to document providing a written plan to families (80%) vs 2%; P .001. In the intervention and control groups, eczema severity and QOL improved between the pre- and postintervention periods. However, there was not a significant difference between the groups on either measure: POEM difference -0.8, 95% confidence interval (CI) -3.2 to 1.7; IDQOL difference -0.1, 95% CI -1.8 to 1.6; CDLQI difference 0.8, 95% CI -0.9 to 2.6.Intervention group providers documented more comprehensive eczema care than control group providers. Although patients improved on all measures in the postintervention period, the ECP did not augment that improvement. |
| Databáze: | OpenAIRE |
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