Video Education Program Reduced Severity Score of Atopic Dermatitis in Pediatric Patients

A video education program on basic skin care is efficacious in its reducing of the severity score of atopic dermatitis (SCORAD), new findings suggest, though additional analyses using a larger sample size may be necessary.¹

These results were the conclusion of new research conducted in Thailand by a team led by Pornthip Jungwattanavanit, from the division of pediatric dermatology at the Chulalongkorn University Faculty of Medicine in Bangkok. The investigators noted that chronic conditions such as atopic dermatitis, also known as eczema, can be benefited from education in the long-term, with improvements to quality of life and diminished disease severity.²

“We created an 8-min educational video on basic skin care as an additional tool to improve parental knowledge,” Jungwattanavanit et al. wrote. “It is currently unclear whether educational videos on basic skin care can effectively reduce disease severity and improve skin conditions for Thai children with [atopic dermatitis]. This research aimed to evaluate the efficacy of basic skin care video education on clinical outcomes of pediatric [atopic dermatitis] patients.”¹

Background and Design

The investigators carried out their randomized controlled trial at King Chulalongkorn Memorial Hospital in Bangkok between June 2023 - February 2024. Those who became participants in the analysis were divided into educational and control groups, both of which were given standard care.

In terms of care, it included verbal instructions from a clinician on points regarding treatment tailored to the severity of their skin conditions, basic skin care management, and recommendations for the purposes of avoiding triggers. Additionally, the educational cohort was given a supplementary video-based education program.

For their key outcomes measured at baseline and following 4 weeks, these for the research team included transepidermal water loss (TEWL), the severity score of atopic dermatitis (SCORAD), skin hydration (SH), levels of sleeplessness, itch, and the accuracy of a patient’s guardian’s skin health awareness.

The investigators’ sample size they deemed necessary was calculated using a projected 10-point improvement in the participants’ SCORAD scores between the 2 arms of the study, derived from prior data. Accounting for a 10% dropout rate, 31 subjects per cohort were deemed necessary to achieve 80% power with an alpha level of .05 in a 2-tailed test.

The investigative team ended up with a total of 73 participants enrolled in their research. Their criteria for patient eligibility included being labled as a pediatric patient under 18 years of age with atopic dermatitis. Those who were guardians would have to be literate in Thai.

Individuals with unclear diagnoses or who were unable to finish out the study were excluded. Both of the groups received the same standard care, but the educational group additionally benefited from the video program. SCORAD, TEWL, SH, pruritus, sleeplessness, and parental knowledge assessments were done at the beginning of the study and following 4 weeks.

Major Findings

The investigative team ultimately involved a total of 70 participants in their research, with 34 being featured in the educational arm and 36 in the control arm of the study. These subjects had a median age of 3.1 years.

The team reported that there were no significant baseline demographics or disease severity differences between the 2 cohorts. They added that by the 4-week follow-up meeting, those included in the educational cohort were found to have demonstrated a substantial improvement in their SCORAD scores versus those in the control group (mean difference −10.93; 95% CI −16.92 to −4.95; P < .001).

However, the investigators also concluded that differences in subjects’ SH (mean difference 3.82; 95% CI −2.7 to 10.33; P = .25) as well as their TEWL (mean difference −1.24; 95% CI −5.72 to 3.24; P = .58) had not been shown to be statistically significant.

“We created an 8-min educational video on basic skin care as an additional tool to improve parental knowledge,” they wrote. “It is currently unclear whether educational videos on basic skin care can effectively reduce disease severity and improve skin conditions for Thai children with [atopic dermatitis]. This research aimed to evaluate the efficacy of basic skin care video education on clinical outcomes of pediatric [atopic dermatitis] patients.”¹

References

1. ^{Jungwattanavanit, P., Wananukul, S., Tempark, T., Chantawarangul, K. and Chatproedprai, S. (2024), Efficacy of a Video Education Program Regarding Basic Skin Care in Pediatric Atopic Dermatitis: A Randomized Controlled Trial. Pediatric Dermatology. https://doi.org/10.1111/pde.15798.}
2. ^{D. Staab, U. von Rueden, R. Kehrt, et al., “Evaluation of a Parental Training Program for the Management of Childhood Atopic Dermatitis,” Pediatric Allergy and Immunology 13, no. 2 (2002): 84–90.}