Singer Hannah M, Levin Laura E, Morel Kimberly D, Garzon Maria C, Stockwell Melissa S, Lauren Christine T
College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Department of Dermatology, Columbia University, New York, NY, USA.
Pediatr Dermatol. 2018 Jul;35(4):453-457. doi: 10.1111/pde.13510. Epub 2018 May 2.
BACKGROUND/OBJECTIVES: Atopic dermatitis is a common, chronic, debilitating disease. Poor adherence to treatment is the most important preventable contributor to adverse outcomes. Thus, improving adherence can improve patient outcomes. Text message reminders with embedded condition-specific information have been shown to improve pediatric immunization adherence but have not been assessed in atopic dermatitis. The objective was to assess the effect of daily text messages on Eczema Area Severity Index scores and caregiver knowledge of atopic dermatitis.
In this pilot randomized controlled trial, caregivers of children with atopic dermatitis enrolled during their initial appointment with a pediatric dermatologist and randomized 1:1 to standard care or daily text messages with patient education material and treatment reminders. Participants completed a multiple-choice atopic dermatitis knowledge quiz at initial and follow-up visits, and Eczema Area Severity Index scores were assessed.
Forty-two patients enrolled, and 30 completed the study: 16 standard care group, 14 text message group. There was no significant difference in Eczema Area Severity Index score between the standard care and text message groups at follow-up, with mean decreases in Eczema Area Severity Index score of 53% and 58%, respectively. Mean score on follow-up atopic dermatitis knowledge quiz was significantly higher in the text message group (84% correct) than in the standard care group (75% correct) (P = .04).
This pilot study did not demonstrate a difference in Eczema Area Severity Index scores with text message reminders. The significantly higher follow-up atopic dermatitis quiz score in the text message group indicates that participants read and retained information from text messages. Limitations include small sample size and short duration of follow-up.
背景/目的：特应性皮炎是一种常见的慢性致残性疾病。治疗依从性差是导致不良结局的最重要的可预防因素。因此，提高依从性可改善患者预后。已证明带有特定疾病信息的短信提醒可提高儿童免疫接种的依从性，但尚未在特应性皮炎中进行评估。目的是评估每日短信对湿疹面积和严重程度指数（EASI）评分以及照顾者对特应性皮炎知识的影响。
在这项前瞻性随机对照试验中，特应性皮炎患儿的照顾者在首次就诊于儿科皮肤科医生时登记入组，并按1:1随机分为标准护理组或接收包含患者教育材料和治疗提醒的每日短信组。参与者在初次和随访就诊时完成了一份特应性皮炎知识多项选择题测验，并评估了湿疹面积和严重程度指数评分。
42名患者入组，30名完成研究：16名在标准护理组，14名在短信组。随访时，标准护理组和短信组的湿疹面积和严重程度指数评分无显著差异，湿疹面积和严重程度指数评分的平均降幅分别为53%和58%。短信组随访时特应性皮炎知识测验的平均得分（正确率84%）显著高于标准护理组（正确率75%）（P = 0.04）。
这项前瞻性研究未显示短信提醒在湿疹面积和严重程度指数评分上有差异。短信组随访时特应性皮炎测验得分显著更高，表明参与者阅读并记住了短信中的信息。局限性包括样本量小和随访时间短。
