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一项针对特应性皮炎患者的数字干预措施的临床疗效:一项前瞻性单中心研究。

Clinical Efficacy of a Digital Intervention for Patients with Atopic Dermatitis: a Prospective Single-Center Study.

作者信息

Gudmundsdóttir Sigrídur Lára, Ballarini Tommaso, Ámundadóttir María L, Mészáros Judit, Eysteinsdóttir Jenna H, Thorleifsdóttir Ragna H, Hrafnkelsdóttir Sigrídur K, Bragadóttir Heida B, Oddsson Saemundur, Silverberg Jonathan I

机构信息

Sidekick Health, Kópavogur, Iceland.

Department of Health Promotion, Sport and Leisure Studies, University of Iceland, Reykjavik, Iceland.

出版信息

Dermatol Ther (Heidelb). 2022 Nov;12(11):2601-2611. doi: 10.1007/s13555-022-00821-y. Epub 2022 Oct 14.

Abstract

INTRODUCTION

Improving disease awareness and treatment adherence is key for the long-term management of atopic dermatitis (AD). Digital interventions can support patients in disease self-management and adopting a healthier lifestyle through behavioral modifications. We aimed to test the clinical efficacy of a digital program in patients with AD.

METHODS

Adults with mild-to-severe AD were recruited for a 6-week feasibility study. The intervention was delivered through a mobile app and consisted of symptom and trigger education, treatment reminders, lifestyle coaching, and healthy lifestyle support. Here we report the secondary outcomes of intervention efficacy on clinical symptoms, as assessed by Scoring Atopic Dermatitis (SCORAD) and Patient-Oriented Eczema Measure (POEM), on health-related quality of life (HR QoL) as assessed by Dermatology Life Quality Index (DLQI), and changes in behaviors related to disease management as assessed by a six-item questionnaire.

RESULTS

Twenty of 21 patients (95.2%) completed the program (81% female, mean age 31.4 years, mean time from diagnosis 26.8 years). Clinical symptoms and patient-reported global severity improved by 44% and 46%, respectively, while HR QoL improved by 41% (p < 0.001 for all measures). Adherence to treatments and preventive measures improved from pre- to post-intervention, including skincare, avoidance of triggers, and disease-related knowledge. A significant interaction was observed between increased treatment adherence and clinical improvement, such that larger clinical improvements were observed in patients with higher treatment adherence.

CONCLUSION

Patients with AD are open to and can benefit from a digitally delivered targeted intervention, as demonstrated by significant improvements in treatment adherence and related clinical outcomes.

摘要

引言

提高疾病认知度和治疗依从性是特应性皮炎(AD)长期管理的关键。数字干预可以通过行为改变来支持患者进行疾病自我管理并采用更健康的生活方式。我们旨在测试一个数字项目对AD患者的临床疗效。

方法

招募了患有轻至重度AD的成年人进行为期6周的可行性研究。干预通过移动应用程序进行,包括症状和诱发因素教育、治疗提醒、生活方式指导以及健康生活方式支持。在此,我们报告干预对临床症状的疗效的次要结果,通过特应性皮炎评分(SCORAD)和患者导向性湿疹评估(POEM)进行评估;对健康相关生活质量(HR QoL)的影响,通过皮肤病生活质量指数(DLQI)进行评估;以及通过一份六项问卷评估的与疾病管理相关行为的变化。

结果

21名患者中有20名(95.2%)完成了该项目(女性占81%,平均年龄31.4岁,从诊断到参与研究的平均时间为26.8年)。临床症状和患者报告的整体严重程度分别改善了44%和46%,而HR QoL改善了41%(所有测量指标p < 0.001)。从干预前到干预后,对治疗和预防措施的依从性有所提高,包括皮肤护理、避免诱发因素以及疾病相关知识。在治疗依从性增加和临床改善之间观察到显著的相互作用,即治疗依从性较高的患者临床改善更大。

结论

AD患者对数字化提供的针对性干预持开放态度并能从中受益,治疗依从性和相关临床结果的显著改善证明了这一点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af39/9588147/fbfb9e6a3088/13555_2022_821_Fig1_HTML.jpg

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