title: Improved management of childhood atopic dermatitis after individually tailored nurse consultations: A pilot study.
abstract: BACKGROUND
  For optimal therapy of atopic dermatitis (AD) in children, parent education for treatment strategies that consider the episodic course and multiple triggers is essential. Regular consultations with doctors often cannot appropriately provide this. Therefore, supplemental patient education tools have been established. We evaluate single nurse consultations, assessing their global benefit, parents' self-confidence, and children's symptoms and sleep disturbance.
  
  
  METHODS
  Parents of children with AD were invited for an individually tailored nurse consultation by the doctor initially consulted in cases where difficulties in implementing care recommendations were detected and established therapeutic patient education (TPE) group programmes were impracticable. Parents' estimation of their own self-confidence, current disease severity and its treatment was assessed by a questionnaire at the consultation and by telephone 14 days later.
  
  
  RESULTS
  Parents of 1628 children (mean age 1.7 yr) attended consultations in 22 centres (317-6 patients; median 38). At follow-up parents indicated a significantly increased self-confidence to handle the recommendations and >90% rated the consultation highly supportive. The frequency of severe symptoms was significantly lower (20% of initial cases), as of moderate symptoms (50%). Median scores for sleep disruption and pruritus decreased by >50%.
  
  
  CONCLUSIONS
  Individually tailored single nurse consultations for AD are associated with a significant benefit for the families after 14 days. We recommend these in addition to the usual medical care in cases where participation in TPE programmes is impossible or a short-time follow-up is required. To substantiate their effect, studies with a long-term follow-up and a control group are warranted.
authors: Department of Paediatric Pneumology and Immunology, University Children's Hospital Charité University Medical Centre, Berlin, Germany.
authors: Claudia
authors: C
authors: Rolinck-Werninghaus
authors: Department of Paediatric Pneumology and Immunology, University Children's Hospital Charité University Medical Centre, Berlin, Germany.
authors: Marion
authors: M
authors: Trentmann
authors: Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Centre, Berlin, Germany.
authors: Andreas
authors: A
authors: Reich
authors: Department of Paediatric Pneumology and Immunology, University Children's Hospital Charité University Medical Centre, Berlin, Germany.
authors: Christine
authors: C
authors: Lehmann
authors: Department of Paediatric Pneumology and Immunology, University Children's Hospital Charité University Medical Centre, Berlin, Germany.
authors: Doris
authors: D
authors: Staab
mesh_terms: D000328:Adult; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D008297:Male; D009726:Nurses; D010290:Parents; D010353:Patient Education as Topic; D010865:Pilot Projects; D057285:Precision Medicine; D011788:Quality of Life; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
keywords: atopic dermatitis; care; consultation; nurse; parents