Wilken Bethany, Zaman M, Asai Y
Translational Institute of Medicine, Department of Medicine, Queen's University, Kingston, ON, Canada.
School of Medicine, Queen's University, Kingston, ON, Canada.
Allergy Asthma Clin Immunol. 2023 Oct 13;19(1):89. doi: 10.1186/s13223-023-00844-w.
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects children and adults. Poor treatment adherence in AD requires interventions to promote self-management; patient education in chronic diseases is key to self-management. Many international AD management guidelines published to date include a recommendation for educating patients as part of their treatment but there are no formal recommendations on how to deliver this knowledge. MAIN: We performed a scoping review to map the existing literature on patient education practices in AD and to highlight the clinical need for improved patient education in AD. The literature search was performed with the online databases MEDLINE, Embase, Grey Matters, ClinicalTrails.gov and the International Clinical Trials Registry Platform (ICTRP). The search strategy yielded 388 articles. Of the 388 articles screened, 16 studies met the eligibility criteria, and the quantitative data was summarized by narrative synthesis. The majority of studies were randomized controlled trials conducted in Europe, Asia and North America. Since 2002, there have been limited studies evaluating patient education in the treatment of AD. Frequent education methods used included group-based educational programs, educational pamphlets, individual consultations and online resources. Education was most commonly directed at caregivers and their children. Only one study compared the efficacy of different education methods. In all included studies, the heterogenous nature of outcome measures and study design limited the consistency of results. Despite the heterogeneity of studies, patient education was shown to improve quality of life (QoL), disease severity and psychological outcomes in AD patients.
This scoping review highlights that patient education is effective in a variety of domains relevant to AD treatment. Further comparative studies and randomized trials with longer-term follow-up are needed to provide validated and consistent patient education recommendations for AD; these may depend on age and population.
特应性皮炎（AD）是一种影响儿童和成人的慢性炎症性皮肤病。AD治疗依从性差需要采取干预措施来促进自我管理；慢性病患者教育是自我管理的关键。迄今为止发布的许多国际AD管理指南都建议将患者教育作为治疗的一部分，但对于如何传授这些知识并没有正式的建议。
我们进行了一项范围综述，以梳理关于AD患者教育实践的现有文献，并强调改善AD患者教育的临床需求。通过在线数据库MEDLINE、Embase、Grey Matters、ClinicalTrails.gov和国际临床试验注册平台（ICTRP）进行文献检索。检索策略共得到388篇文章。在筛选的388篇文章中，有16项研究符合纳入标准，并通过叙述性综合对定量数据进行了总结。大多数研究是在欧洲、亚洲和北美进行的随机对照试验。自2002年以来，评估AD治疗中患者教育的研究有限。常用的教育方法包括基于小组的教育项目、教育手册、个体咨询和在线资源。教育最常针对照顾者及其子女。只有一项研究比较了不同教育方法的效果。在所有纳入研究中，结局指标和研究设计的异质性限制了结果的一致性。尽管研究存在异质性，但患者教育被证明可以改善AD患者的生活质量（QoL）、疾病严重程度和心理结局。
这项范围综述强调患者教育在与AD治疗相关的多个领域是有效的。需要进一步的比较研究和长期随访的随机试验，以提供经过验证且一致的AD患者教育建议；这些建议可能取决于年龄和人群。
