title: Multidisciplinary interventions in the management of atopic dermatitis.
abstract: Atopic dermatitis (AD) is the most common pediatric skin disease. AD has a significant effect on patient and family quality of life caused by intense pruritus, sleep disruption, dietary and nutritional concerns, and psychological stress associated with the disease and its management. Multidisciplinary approaches to AD care have been developed in appreciation of the complex interplay among biological, psychological, behavioral, and dietary factors that affect disease control and the wide range of knowledge, skills, and support that patients and families require to effectively manage and cope with this condition. Common components of multidisciplinary treatment approaches include medical evaluation and management by an AD specialist, education and nursing care, psychological and behavioral support, and nutritional assessment and guidance. Models of care include both clinical programs and structured educational groups provided as adjuncts to standard clinical care. Available evidence suggests beneficial effects of multidisciplinary interventions in improving disease severity and quality of life, particularly for patients with moderate-to-severe disease. Additional research is needed to identify the best candidates for the various multidisciplinary approaches and evaluate the cost-effectiveness of these programs.
authors: Allergy Program, Division of Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass. Electronic address: jennifer.lebovidge@childrens.harvard.edu.
authors: Jennifer S
authors: JS
authors: LeBovidge
authors: Center for Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Mass.
authors: Wendy
authors: W
authors: Elverson
authors: Allergy Program, Division of Immunology, Boston Children's Hospital, Boston, Mass.
authors: Karol G
authors: KG
authors: Timmons
authors: Harvard Medical School, Boston, Mass; Dermatology Program, Division of Immunology, Boston Children's Hospital, Boston, Mass; Department of Dermatology, Massachusetts General Hospital, Boston, Mass.
authors: Elena B
authors: EB
authors: Hawryluk
authors: Harvard Medical School, Boston, Mass; Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Mass.
authors: Corinna
authors: C
authors: Rea
authors: Dermatology Program, Division of Immunology, Boston Children's Hospital, Boston, Mass; Department of Dermatology, Boston University School of Medicine, Boston, Mass.
authors: Margaret
authors: M
authors: Lee
authors: Allergy Program, Division of Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
authors: Lynda C
authors: LC
authors: Schneider
mesh_terms: D002202:Capital Financing; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000379:methods; D003876:Dermatitis, Atopic / Q000175:diagnosis* / Q000628:therapy*; D019468:Disease Management; D018166:Health Care Reform; D006282:Health Personnel; D006801:Humans; D000070516:Intersectoral Collaboration; D010348:Patient Care Team
keywords: Atopic dermatitis; eczema; education; multidisciplinary; nursing; nutrition; psychology; quality of life; treatment