Intervenções educativas na dermatite atópica em crianças: o que há de novo?
Educational interventions for atopic dermatitis in children: what's new?
Renata Robl Imoto; Thais Braga Cerqueira; Vânia Oliveira de Carvalho
Resumo
A educação dos cuidadores dos pacientes com dermatite atópica (DA) pode possibilitar a melhora da qualidade de vida e minimizar a gravidade da doença, já que esta tem um imensurável impacto emocional, social e financeiro nas famílias dos doentes. Entretanto, não há um consenso de qual o escopo ideal e frequência para a entrega das informações educativas sobre a patologia e terapêutica. Esta é uma revisão integrativa de literatura cujo objetivo foi avaliar estudos sobre a eficácia de intervenções educativas para pais e pacientes pediátricos com DA na gravidade da doença e na qualidade de vida. Foi realizada uma busca nas bases de dados do PubMed e MEDLINE, em acesso realizado em 08/08/2022, incluindo publicações de 2000 a 2022, nos idiomas português e inglês, incluindo os termos: “atopic dermatitis”, “education program”, “therapeutic education”. Foram incluídos 15 artigos nesta revisão. As metodologias dos estudos são diversas e as ferramentas utilizadas pelos pesquisadores também são heterogêneas, o que dificulta a comparação dos resultados. Dos temas abordados, o cuidado da pele e/ou rotinas básicas foram temas sempre incluídos. E, apesar da literatura demonstrar melhora na gravidade da doença e na qualidade de vida dos cuidadores e pacientes com DA após as intervenções, isso não foi um consenso entre os autores. A educação terapêutica pode ser útil para aumentar a adesão ao tratamento e prevenção de complicações; porém, estudos prospectivos com casuística maior são primordiais para esclarecer qual o escopo ideal e frequência para a entrega destas informações.
Palavras-chave
Abstract
Educating the caregivers of patients with atopic dermatitis may lead to improved quality of life and help minimize disease severity, since the pathology has an immeasurable emotional, social, and financial impact on the patient’s families. However, there is no consensus on the ideal scope and frequency for providing educational information about atopic dermatitis and its treatment. The purpose of this integrative literature review was to evaluate studies on the effectiveness of educational interventions for parents and pediatric patients with atopic dermatitis regarding disease severity and quality of life. On August 8, 2022, we searched the PubMed and MEDLINE databases for studies published between 2000 and 2022 in Portuguese or English that included the terms: "atopic dermatitis", "education program", and/or "therapeutic education". A total of 15 articles were included in this review. The studies’ methodologies and tools were heterogeneous, impeding comparison of the results. Of the covered topics, skin care and/ or basic routines were always included. Although the literature showed that therapeutic education improved disease severity and quality of life for both caregivers and patients, there was no consensus among the authors. Therapeutic education may help increase treatment adherence and prevent complications. However, prospective studies with larger populations are essential for
Keywords
References
1. Mancini AJ, Kaulback K, Chamlin SL. The socioeconomic impact of atopic dermatitis in the United States: a systematic review. Pediatr Dermatol. 2008;25(1):1-6.
2. Hanifin J, Tofte S. Patient education in the long-term management of atopic dermatitis. Dermatol Nurs. 1999;11(4):284-9.
3. García-Soto L, Martín-Masot R, Espadafor-López B, Burgos AMMC, Tercedor-Sánchez J. Evaluation of atopy schools for parents. Allergol Immunopathol. 2021;49(2):1-5.
4. Staab D, Diepgen TL, Fartasch M, Kupfer J, Lob-Corzilius T, Ring J, et al. Age related, structured educational programmes for the management of atopic dermatitis in children and adolescents: multicentre, randomised controlled trial. BMJ 2006;332(7547):933-8.
5. Barbarot S, Boralevi F, Shourick J, Sampogna F, Mahé E, Merhand S, et al. Characteristics of children and adolescents with atopic dermatitis who attended therapeutic patient education. J Eur Acad Dermatol Venereol. 2021 Nov;35(11):2263-2269. doi: 10.1111/jdv.17526.
6. Zhao M, Liang Y, Shen C, Wang Y, Ma L, Ma X. Patient education programs in pediatric atopic dermatitis: a systematic review of randomized controlled trials and meta-analysis. Dermatol Ther. 2020;10(3):449-64.
7. Wollenberg A, Kinberger M, Arents B, Aszodi N, Avila Valle G, Barbarot S, et al. European guideline (EuroGuiDerm) on atopic eczema - part II: non-systemic treatments and treatment recommendations for special AE patient populations. J Eur Acad Dermatol Venereol. 2022 Nov;36(11):1904-26. doi: 10.1111/jdv.18429.
8. Chiesa Fuxench ZC, Block JK, Boguniewicz M, Boyle J, Fonacier L, Gelfand JM, et al. Atopic Dermatitis in America Study: A Cross-Sectional Study Examining the Prevalence and Disease Burden of Atopic Dermatitis in the US Adult Population. J Invest Dermatol. 2019 Mar;139(3):583-90. doi: 10.1016/j.jid.2018.08.028.
9. Drucker AM, Wang AR, Li WQ, Sevetson E, Block JK, Qureshi AA. The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. J Invest Dermatol. 2017 Jan;137(1):26-30. doi: 10.1016/j.jid.2016.07.012.
10. Chamlin SL, Mattson CL, Frieden IJ, Williams ML, Mancini AJ, Cella D, et al. The price of pruritus: sleep disturbance and cosleeping in atopic dermatitis. Arch Pediatr Adolesc Med. 2005 Aug;159(8):745‑50. doi: 10.1001/archpedi.159.8.745.
11. Ohya Y, Williams H, Steptoe A, Saito H, Iikura Y, Anderson R, et al. Psychosocial factors and adherence to treatment advice in childhood atopic dermatitis. J Invest Dermatol. 2001 Oct;117(4):852-7. doi: 10.1046/j.0022-202x.2001.01475.x.
12. Su JC, Kemp AS, Varigos GA, Nolan TM. Atopic eczema: its impact on the family and financial cost. Arch Dis Child. 1997 Feb;76(2):159‑62. doi: 10.1136/adc.76.2.159.
13. Beattie PE, Lewis-Jones MS. An audit of the impact of a consultation with a paediatric dermatology team on quality of life in infants with atopic eczema and their families: further validation of the Infants' Dermatitis Quality of Life Index and Dermatitis Family Impact score. Br J Dermatol. 2006 Dec;155(6):1249-55. doi: 10.1111/j.1365-2133.2006.07525.x.
14. Moore K, David TJ, Murray CS, Child F, Arkwright PD. Effect of childhood eczema and asthma on parental sleep and well-being: a prospective comparative study. Br J Dermatol. 2006 Mar;154(3):514-8. doi: 10.1111/j.1365-2133.2005.07082.x.
15. Abramovits W. A clinician's paradigm in the treatment of atopic dermatitis. J Am Acad Dermatol. 2005 Jul;53(Suppl 1):S70-7. doi: 10.1016/j.jaad.2005.04.032.
16. Nabovati E, Farzandipour M, Heidarzadeh Arani M, Akbari H, Sharif R, Anvari S. The use of mobile phone functionalities by patients with asthma and their desire to use for self-care purposes. BMC Med Inform Decis Mak. 2020 Oct 30;20(1):281. doi: 10.1186/s12911-020-01301-z.
17. Grillo M, Gassner L, Marshman G, Dunn S, Hudson P. Pediatric atopic eczema: the impact of an educational intervention. Pediatr Dermatol. 2006 Sep-Oct;23(5):428-36.
18. Pustisek N, Situm M, Vurnek Zivković M, Ljubojević Hadzavdić S, Vurnek M, Niseteo T. The significance of structured parental educational intervention on childhood atopic dermatitis: a randomized controlled trial. J Eur Acad Dermatol Venereol. 2016 May;30(5):806-12. doi: 10.1111/jdv.13519.
19. Chinn DJ, Poyner T, Sibley G. Randomized controlled trial of a single dermatology nurse consultation in primary care on the quality of life of children with atopic eczema. Br J Dermatol. 2002 Mar;146(3):432-9. doi: 10.1046/j.1365-2133.2002.04603.x.
20. Shaw M, Morrell DS, Goldsmith LA. A study of targeted enhanced patient care for pediatric atopic dermatitis (STEP PAD). Pediatr Dermatol. 2008 Jan-Feb;25(1):19-24. doi: 10.1111/j.1525-1470.2007.00575.x.
21. Weber MB, Fontes Neto P de T, Prati C, Soirefman M, Mazzotti NG, Barzenski B, et al. Improvement of pruritus and quality of life of children with atopic dermatitis and their families after joining support groups. J Eur Acad Dermatol Venereol. 2008 Aug;22(8):992-7. doi: 10.1111/j.1468-3083.2008.02697.x
22. Moore EJ, Williams A, Manias E, Varigos G, Donath S. Eczema workshops reduce severity of childhood atopic eczema. Australas J Dermatol. 2009 May;50(2):100-6. doi: 10.1111/j.1440-0960.2009.00515.x
23. Schuttelaar ML, Vermeulen KM, Drukker N, Coenraads PJ. A randomized controlled trial in children with eczema: nurse practitioner vs. dermatologist. Br J Dermatol. 2010 Jan;162(1):162-70. doi: 10.1111/j.1365-2133.2009.09502.x.
24. Futamura M, Masuko I, Hayashi K, Ohya Y, Ito K. Effects of a short-term parental education program on childhood atopic dermatitis: a randomized controlled trial. Pediatr Dermatol. 2013 Jul-Aug;30(4):438-43. doi: 10.1111/pde.12105.
25. Park GY, Park HS, Cho S, Yoon HS. The Effectiveness of Tailored Education on the Usage of Moisturizers in Atopic Dermatitis: A Pilot Study. Ann Dermatol. 2017 Jun;29(3):360-362. doi: 10.5021/ad.2017.29.3.360.
26. Liang Y, Tian J, Shen CP, Xu F, Wang H, Li P, et al. Therapeutic patient education in children with moderate to severe atopic dermatitis: a multicenter randomized controlled trial in China. Clin Exp Allergy. 2018;35(1):70-5.
27. Kartan S, Kim M, Lauren C. Video-based education in pediatric atopic dermatitis. J Am Acad Dermatol. 2018;79(3):AB312.
28. Singer HM, Levin LE, Morel KD, Garzon MC, Stockwell MS, Lauren CT. Texting atopic dermatitis patients to optimize learning and eczema area and severity index scores: a pilot randomized control trial. Pediatr Dermatol. 2018;35(4):453-57.
29. Dufresne H, Bekel L, Compain S, Deladrière E, Bellon N, Bodemer C, et al. Efficiency of a therapeutic patient education programme in children with severe atopic dermatitis. J Eur Acad Dermatol Venereol. 2020;34(10):e648-51.
30. LeBovidge JS, Timmons K, Delano S, Greco KF, DeFreitas F, Chan F, et al. Improving patient education for atopic dermatitis: A randomized controlled trial of a caregiver handbook. Pediatr Dermatol. 2021 Mar;38(2):396-404. doi: 10.1111/pde.14519.
31. Aubert-Wastiaux H, Moret L, Le Rhun A, Fontenoy AM, Nguyen JM, Leux C, et al. Topical corticosteroid phobia in atopic dermatitis: a study of its nature, origins and frequency. Br J Dermatol. 2011 Oct;165(4):808-14. doi: 10.1111/j.1365-2133.2011.10449.x.
32. Zhao M, Liang Y, Song F, Ma L, Wang Y, Gao W, et al. Preventive Antenatal Educational Program on Allergic Diseases (PAEPAD) versus standard antenatal care for prevention of atopic dermatitis: study protocol for a single-centre, investigator-blinded randomised controlled trial. BMJ Open. 2022 Jan 25;12(1):e048083. doi: 10.1136/bmjopen-2020-048083.
33. Warsi A, Wang PS, LaValley MP, Avorn J, Solomon DH. Self-management education programs in chronic disease: a systematic review and methodological critique of the literature. Arch Intern Med. 2004 Aug 9-23;164(15):1641-9. doi: 10.1001/archinte.164.15.1641.
34. Guevara JP, Wolf FM, Grum CM, Clark NM. Effects of educational interventions for self management of asthma in children and adolescents: systematic review and meta-analysis. BMJ. 2003 Jun 14;326(7402):1308-9. doi: 10.1136/bmj.326.7402.1308.
35. Ellis C, Luger T, Abeck D, Allen R, Graham-Brown RA, De Prost Y, et al.; ICCAD II Faculty. International Consensus Conference on Atopic Dermatitis II (ICCAD II): clinical update and current treatment strategies. Br J Dermatol. 2003 May;148 Suppl 63:3-10. doi: 10.1046/j.1365-2133.148.s63.1.x.
Submitted date:
09/30/2022
Accepted date:
02/11/2023
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email