CoChat
Sign Up
Cited by 5Dermatology and Skin DiseasesClinical practice guidelines implementationAsthma and respiratory diseases

Where and How Have Written Action Plans for Atopic Eczema/Dermatitis Been Developed and Evaluated? Systematic Review

Open access
Thandi, Charankumal Singh, Constantinou, Sophie, Vincent, Rosie, Ridd, Matthew J.·2023·Skin Health and Disease
DOI 10.1002/ski2.213PMC PMC10233085
Open this paper in CoChat — free accountOpen PDF

Abstract

Background: Atopic eczema/dermatitis is a common inflammatory condition which affects 15%–30% of children and 2%–10% of adults. It can have a significant impact and its management can be challenging. It is important for patients, parents, and caregivers to know how to look after their skin. Objectives: To identify and review written eczema action plans (WAPs) that are available internationally for use by patients, parents, and caregivers. Methods: We followed Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines. We searched relevant databases (MEDLINE, Embase, COCHRANE) from inception until March 2022. We sought grey literature via Google searches and professional networks. Database search results were independently reviewed by two different reviewers. With identified WAPs, we assessed length, appearance, content, how it was developed and whether it had been evaluated. Results: From 312 abstracts, supplemented by other searches, we identified 20 unique eczema WAPs. From nine countries, all were written in English with 18 were designed for children. For the majority, it was unclear whether any development work preceded their creation or the intended clinical setting for use. Nineteen had a stepwise approach, 17 advised when to seek help, 6 were visually appealing and 6 had a rationale behind treatment documented in the WAP. Only three had been evaluated in clinical trials. Conclusion: Further evaluation is needed to assess the effectiveness of the WAPs that currently exist, prior to creating further WAPs. Patient and caregiver involvement is needed in any future work.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1002/ski2.213

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • There is a long history in medicine of written action plans, mainly used in the treatment of asthma bronchiale, but also in the treatment of atopic dermatitis.

    “For instance, there is a long history in medicine of written action plans, which have mainly been used in the treatment of asthma bronchiale (Zemek et al., 2008), but also in the treatment of atopic dermatitis (Thandi et al., 2023).”

    From The effectiveness of implementation intentions in children: A systematic review and meta‐analysis (2026) · cites this paper as Thandi et al., 2023

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

No references could be resolved yet.

Research works printed but not linked: 24

  1. [1]Le Roux E, Edwards PJ, Sanderson E, Barnes RK, Ridd MJ. The content and conduct of GP consultations for dermatology problems: a cross‐sectional study. Br J Gen Pract. 2020; 70(699): e723– e730. Available from: https://research-information.bris.ac.uk/en/publications/the-content-and-conduct-of-gp-consultations-for-dermatology-probl 32895240 PMC7480176
  2. [2]Baron SE, Cohen SN, Archer CB, on behalf of British Association of Dermatologists and Royal College of General Practitioners. Guidance on the diagnosis and clinical management of atopic eczema. Clin Exp Dermatol. 2012; 37(Suppl. 1): 7– 12. 10.1111/j.1365-2230.2012.04336.x 22486763 · DOI
  3. [3]Beattie PE, Lewis‐Jones MS. A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases. Br J Dermatol. 2006; 155(1): 145– 51. 10.1111/j.1365-2133.2006.07185.x 16792766 · DOI · Paper page
  4. [4]Wollenberg A, Barbarot S, Bieber T, Christen‐Zaech S, Deleuran M, Fink‐Wagner A, et al. Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venereol. 2018; 32(6): 850– 78. 10.1111/jdv.14888 29878606 · DOI · Paper page
  5. [5]Paller AS, Siegfried EC, Thaçi D, Wollenberg A, Cork MJ, Arkwright PD, et al. Efficacy and safety of dupilumab with concomitant topical corticosteroids in children 6 to 11 years old with severe atopic dermatitis: a randomized, double‐blinded, placebo‐controlled phase 3 trial. J Am Acad Dermatol. 2020; 83(5): 1282– 93. 10.1016/j.jaad.2020.06.054 32574587 · DOI
  6. [6]Powell K, Le Roux E, Banks J, Ridd MJ. GP and parent dissonance about the assessment and treatment of childhood eczema in primary care: a qualitative study. BMJ Open. 2018; 8(2): 19633. 10.1136/bmjopen-2017-019633. Available from: http://bmjopen.bmj.com/ PMC5829900 29449296 · DOI
  7. [8]Ridd MJ, King AJL, Le Roux E, Waldecker A, Huntley AL. Systematic review of self‐management interventions for people with eczema. Br J Dermatol. 2017; 177(3): 719– 34. 10.1111/bjd.15601 28432696 PMC5637890 · DOI
  8. [9]Powell K, Le Roux E, Banks JP, Ridd MJ. Developing a written action plan for children with eczema: a qualitative study. Br J Gen Pract. 2018; 68(667): e81– e89. 10.3399/bjgp17x693617. Available from: https://bjgp.org/content/68/667/e81 29203680 PMC5774967 · DOI
  9. [10]Gibson PG, Powell H. Written action plans for asthma: an evidence‐based review of the key components. Thorax. 2004; 59(2): 94– 9. 10.1136/thorax.2003.011858 14760143 PMC1746945 · DOI
  10. [11]Gibson PG, Coughlan J, Wilson AJ, Abramson M, Haywood P, Bauman A, et al. Self‐management education and regular practitioner review for adults with asthma. Cochrane Database Syst Rev. 2002; 3: 1– 69. Accessed 5 Mar 2022. 12535399
  11. [12]Agrawal SK, Singh M, Mathew JL, Malhi P. Efficacy of an individualized written home‐management plan in the control of moderate persistent asthma: a randomized, controlled trial. Acta Paediatr. 2005; 94(12): 1742– 6. 10.1111/j.1651-2227.2005.tb01847.x 16421033 · DOI
  12. [13]Gallefoss F, Bakke PS. How does patient education and self‐management among asthmatics and patients with chronic obstructive pulmonary disease affect medication? Am J Respir Crit Care Med. 1999; 160(6): 2000– 5. 10.1164/ajrccm.160.6.9901028. Available from: https://europepmc.org/article/MED/10588620 10588620 · DOI
  13. [14]Ghosh CS, Ravindran P, Joshi M, Stearns SC. Reductions in hospital use from self management training for chronic asthmatics. Soc Sci Med. 1998; 46(8): 1087– 93. 10.1016/s0277-9536(97)10047-8 9579760 · DOI
  14. [15]Moher D, Liberati A, Tetzlaff J, Altman DG, Altman D, Antes G, et al. Preferred reporting items for systematic reviews and meta‐analyses: the PRISMA statement. PLoS Med. 2009; 6(7): e1000097. 10.1371/journal.pmed.1000097 19621072 PMC2707599 · DOI · Paper page
  15. [18]Chisolm SS, Taylor SL, Balkrishnan R, Feldman SR. Written action plans: potential for improving outcomes in children with atopic dermatitis. J Am Acad Dermatol. 2008; 59(4): 677– 83. Available from: https://explore.openaire.eu/search/publication?pid=10.1016%2Fj.jaad.2008.04.025 18513825 · DOI
  16. [19]Rork JF, Sheehan WJ, Gaffin JM, Timmons KG, Sidbury R, Schneider LC, et al. Parental response to written eczema action plans in children with eczema. Arch Dermatol. 2012; 148(3): 391– 2. 10.1001/archdermatol.2011.2267 22431785 PMC3328408 · DOI
  17. [20]Shi VY, Nanda S, Lee K, Armstrong AW, Lio PA. Improving patient education with an eczema action plan: a randomized controlled trial. JAMA Dermatol. 2013; 149(4): 481– 3. 10.1001/jamadermatol.2013.2143 23553035 · DOI
  18. [21]Rea CJ, Tran KD, Jorina M, Wenren LM, Hawryluk EB, Toomey SL. A randomized controlled trial of an eczema care plan. Acad Pediatr. 2018; 18(7): 789– 96. 10.1016/j.acap.2018.02.015 29505898 · DOI
  19. [22]Brown J, Weitz NW, Liang A, Stockwell MS, Friedman S. Does an eczema action plan improve atopic dermatitis? A single‐site randomized controlled trial. Clin Pediatr (Phila). 2018; 57(14): 1624– 9. 10.1177/0009922818795906 30141340 · DOI
  20. [23]Brar KK, Nicol NH, Boguniewicz M. Strategies for successful management of severe atopic dermatitis. J Allergy Clin Immunol Pract. 2019; 7(1): 1– 16. 10.1016/j.jaip.2018.10.021 30598172 · DOI
  21. [30]How C, Quah J, Koh M. Simply eczema. Singap Med J. 2013; 54(5): 247– 50. 10.11622/smedj.2013101 23716147 · DOI
  22. [34]Lyons JJ, Milner JD, Stone KD. Atopic dermatitis in children: clinical features, pathophysiology and treatment. Immunol Allergy Clin. 2015; 35(1): 161– 83. 10.1016/j.iac.2014.09.008. Available from: http://pmc/articles/PMC4254569/ PMC4254569 25459583 · DOI
  23. [35]Duhovic C, Mohsin M, Duarte‐Williamson E, Baron S. Written treatment plans in atopic eczema management in children. Br J Dermatol. 2016; 175(6): 1361– 2. 10.1111/bjd.14651 27061093 · DOI
  24. [36]Schmitt J, Spuls PI, Thomas KS, Simpson E, Furue M, Deckert S, et al. The Harmonising Outcome Measures for Eczema (HOME) statement to assess clinical signs of atopic eczema in trials. J Allergy Clin Immunol. 2014; 134(4): 800– 7. 10.1016/j.jaci.2014.07.043 25282560 · DOI · Paper page

Cited by

Sorted by citations

Authors
Thandi, C. S., Constantinou, S., Vincent, R., & Ridd, M. J.
Affiliations
  • Bristol Royal Infirmary (GB)
  • University of Bristol (GB)
Corresponding author
Thandi, Charankumal Singh
ORCID
Venue
Skin Health and Disease
Publisher
Oxford University Press (OUP)
Published
2023-03-22
Volume
3
Issue
3
Pages
e213-e213
ISSN
2690-442X (ISSN-L)
DOI
10.1002/ski2.213
PMC
PMC10233085
OpenAlex
W4360616817
Cited by
5
References
0
Citations by year
2026: 2 · 2024: 1 · 2023: 2
FWCI
0.21
Type
journal article
Language
en
Open access
Licence
Locations
  • Skin Health and Disease (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Bristol Research (University of Bristol) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Explore Bristol Research (submittedVersion, cc-by)
Funders
  • National Institute for Health Research
  • Academic Clinical Fellowship
Topics
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
Keywords
atopic dermatitis, written action plans, eczema management, patient education, children, caregivers, treatment rationale, clinical trial evaluation, patient and carer involvement

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review