Implementation and Evaluation of a Patient Action Plan for Patients with Atopic Dermatitis

Background: Management and treatment of atopic dermatitis (AD) are complex and therefore bear the risk of therapeutic failure. Individualised patient action plans for patients and for caregivers have been shown to improve AD management, eczema monitoring and therapy adherence. Little is known about the use of patient action plans in the adult setting. Objectives: This project aimed at implementing a patient action plan to improve eczema management and evaluating its effects on disease severity and patient-related outcomes. Methods: This quality improvement project had a pretest-posttest design and evaluated AD severity and patient-related outcomes after implementing a patient action plan. A convenience sample of 20 adult patients with AD was included. Socio-demographic, diagnostic and clinical variables were collected from the electronic health records. Trained staff assessed AD severity using SCORing Atopic Dermatitis (SCORAD) and person-centred dermatology self-care index (PeDeSI-G) pre as well as 1-month postintervention. Patients completed dermatology life quality index (DLQI) and patient benefit index (PBI). For comparison of SCORAD, DLQI, PeDeSI-G, paired t-test was applied. PBI was presented using descriptive statistics. ResultsUpon intervention, a significant decrease of disease severity (p < 0.0001), in parallel with a significant decrease of DLQI (p < 0.001) and PeDeSI-G (p < 0.0001) was observed. A PBI >= 1 was reached in 95% of participants (mean 2.73; SD 0.9). Conclusions: Our findings confirm the importance of providing patient action plans to AD patients to achieve best treatment results. Based on our experience, we plan to modify the action plan by including both topical and systemic therapies, and to translate it into several languages.