Empower Your Patients to Monitor Their Eczema Symptoms

Atopic dermatitis is a chronic disease requiring long-term monitoring of symptoms and triggers. Patients can proactively monitor their eczema with a new, easy-to-use mobile app.

Atopic dermatitis (AD) is a chronic, long-term disease,¹ with dysfunctional skin barrier function, often irritated by allergen penetration, leading to xerosis, inflammation, pruritus, and other clinical signs of AD.^2-4 Many patients with AD, especially those with moderate or severe disease, also experience negative emotional, psychological, and social impacts. The selection of appropriate treatment is guided by many factors, including disease severity and impact to patient quality of life (QoL). Basic management of AD, whether a mild or severe case, also emphasizes appropriate skin care measures and trigger avoidance.⁵ 

The guidelines of care for the management of AD by the American Academy of Dermatology recommend the use of educational interventions for patients and caregivers.⁶ However, formal, structured, multidisciplinary educational programs led by a health care provider (HCP) can be taxing on a practice’s resources, and there is no current evidence-based recommendation for conducting these programs. Organizations such as the National Eczema Association (NEA) can play a pivotal role in filling that gap with educational and networking tools for patients and caregivers created in consultation with an expert group of medical and scientific professionals. Most recently, NEA released its latest patient-centered tool, EczemaWise, to help patients with AD track and monitor their disease.⁷

In a press release, NEA president and chief executive officer Julie Block said its patient community noted a great need for an effective, easy-to-use tool to track triggers and symptoms of eczema.⁸ Likewise, HCPs want a tool that offers eczema-specific tracking and information in line with evidence-based medicine.⁸ The new EczemaWise app fills this void for both parties. This new tool was created with the consultation of patients and HCPs, including experts Anna Fishbein, MD; Peter Lio, MD; Vivian Shi, MD; Eric Simpson, MD; Jerry Tan, MD; Suing Lockhart, NP; and Anne Weissler, PA.

The app combines a number of logs for symptoms and triggers in one central place (Figure), including:

• Skin, which allows users to detail the severity and location of eczematous lesions. This tracker integrates Patient-Orientated SCORing Atopic Dermatitis (PO-SCORAD), which helps determine severity when combined with other functions
• Itch and sleep, which significantly affect QoL and are measured by a Numeric Rating Scale (NRS) as part of PO-SCORAD
• Pain and stress, which are on a NRS and may be common yet underreported symptoms and triggers of flares
• Triggers, including common metals, chemicals, irritants, and environmental allergens. Users can also add their own triggers
• Diet, which can help track food allergies and water consumption

Also of particular interest to HCPs is the Treatment Tracker. Whether due to complicated regimens, forgetfulness, or other factors, adherence can be difficult for the patient (or their caregiver) and frustrating for HCPs. The Treatment Tracker of EczemaWise can aid patients in following their prescribed regimen by allowing them to select the products used and the time of application/administration. Users can set a reminder to help continue to stay on track with their therapy, possibly reducing the burden of adherence and creating a routine.

This centralized app specific to patients with eczema can empower them, or their caregiver, to take a more active approach to their health care. The app’s use of validated patient-reported measures to collect data regarding disease and lifestyle gives the patient the opportunity to better understand their own eczema. This knowledge translates into more informed discussions with HCPs about specific items of concern, from QoL factors to new-onset lesions, and gives HCPs quick insights into how well-controlled a patient’s disease has been since the last visit.  Most importantly, this information gives patients and providers an opening to engage in the shared decision-making process.

Providers are encouraged to visit eczemawise.org for more information.

References
1. Margolis JS, Abuabara K, Bilker W, Hoffstad O, Margolis DJ. Persistence of mild to moderate atopic dermatitis. JAMA Dermatol. 2014;150(6):593-600. doi:10.1001/jamadermatol.2013.10271

2. Wollenberg A, Christen-Zäch S, Taieb A, et al. ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol. Published online November 17, 2020. doi:10.1111/jdv.16892

3. Abuabara K, Margolis DJ, Langan SM. The long-term course of atopic dermatitis. Dermatol Clin. 2017;35(3):291-297. doi:10.1016/j.det.2017.02.003

4. Kolb L, Ferrer-Bruker SJ. Atopic dermatitis. In: StatPearls. Treasure Island; 2020. Updated August 13, 2020. Accessed November 25, 2020. https://www.ncbi.nlm.nih.gov/books/NBK448071/

5. Boguniewicz M, Fonacier L, Guttman-Yassky E, Ong PY, Silverberg J, Rosen Farrar J. Atopic dermatitis yardstick: practical recommendations for an evolving therapeutic landscape. Ann Allergy Asthma Immunol. 2018;120(1):10-22.e2. doi:10.1016/j.anai.2017.10.039

6. Sidbury R, Tom WL, Bergman JN, et al. Guidelines of care for the management of atopic dermatitis. Section 4. Prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol. 2014;71(6):1218-1233. doi:10.1016/j.jaad.2014.08.038

7. First-of-its-kind app aims to help those with eczema better manage condition. Press release. National Eczema Association. October 13, 2020. Accessed November 25, 2020. https://www.prnewswire.com/news-releases/first-of-its-kind-app-aims-to-help-those-with-eczema-better-manage-condition-301150769.html

8. van Galen LS, Xu X, Koh MJA, Thng S, Car J. Eczema apps conformance with clinical guidelines: a systematic assessment of functions, tools and content. Br J Dermatol. 2020;182(2):444-453. doi:10.1111/bjd.18152