Eczema Care Online (ECO): two randomised controlled trials to test clinical and cost-effectiveness of online interventions to support eczema self-care

Conference:

SAPC ASM 2020 - cancelled due to pandemic

Talk Code:

F.10

Presenter:

Ingrid Muller

Twitter:

@IngridMuller7

Co-authors:

Ingrid Muller1, Lucy Yardley1, Paul Little1, Hywel Williams2, Jo Chalmers2, Paul Leighton2, Matthew J Ridd3, Sandra Lawton4, Beth Stuart1, Gareth Griffiths5, Jacqui Nuttall5, Tracey Sach6, Sinead Langan7, Amanda Roberts2, Amina Ahmed2, Kate Greenwell1, Katy Sivyer1, Sylvia Wilczynska1, Julie Hooper

Author institutions:

1Primary Care, Population Sciences and Medical Education, University of Southampton, 2Centre of Evidence Based Dermatology, University of Nottingham, 3School of Social & Community Medicine, University of Bristol, 4Rotherham NHS Trust, 5Southampton Clinical Trials Unit, 6Health Economics Group, Norwich Medical School, University of East Anglia, 7London School of Hygiene and Tropical Medicine

Problem

Eczema is a common inflammatory skin disorder characterised by red itchy skin and dryness. Eczema can lead to poor quality of life due to itching or bleeding skin and broken sleep. A common cause of poor control of eczema is the underuse of effective treatments. Reasons for underuse include concerns about safety of treatments, time consuming treatments, and insufficient or conflicting advice about how to use treatments.

Approach

We have developed two online interventions to support self-care for people with eczema; one for young people aged 13-25 years and one for parents and carers of children aged 0-12 years. The interventions support self-management of eczema using tailored content delivered in a series of modules, accessible from mobile devices and computers. Interventions have been iteratively developed following evidence, theory and the Person-Based Approach. We are currently carrying out two randomised controlled trials to assess the effectiveness of:1. the ECO intervention in young people with eczema aged 13-25 years 2. the ECO intervention in parents and carers of children with eczema aged 0-12 years Both trials will include an internal pilot phase and nested health economic and process evaluation studies.

Findings

200 participants will be recruited into each trial from UK Primary Care. Participants will be invited to participate if they are:• a young person aged 13-25 years or a parent/carer of a child aged 0-12 years• AND they have a recorded diagnosis of eczema in their records and have obtained a prescription for this in the past 12 monthsPotential participants with a Patient-Oriented Eczema Measure score less than 5 will be excluded as having very mild or quiescent eczema.Participants will be randomised to one of two groups:1. Usual care (with access to the online intervention after 52 weeks of follow-up)2. Usual care plus immediate access to the online intervention The primary outcome for both trials will be eczema severity over 24 weeks measured by 4-weekly Patient-Oriented Eczema Measure (POEM) which measures frequency of symptoms. Secondary outcomes include: Quality of Life, long-term eczema control, itch intensity measure, enablement, service use and medication use.

Consequences

If these interventions prove to be effective, health professionals would be encouraged to recommend their use as part of standard care. Improved self-care has the potential to benefit patients and carers through improved control of eczema.

Submitted by:

Ingrid Muller

Funding acknowledgement:

This study is funded by the NIHR Programme Grants for Applied Research (RP-PG-0216-20007). Data collection for Healthtalk.org was funded by National Institute for Health Research under its Research for Patient Benefit scheme (PB-PG-0213-30006).