Q&A: Developing a Universal Eczema Action Plan

​​​​​​Evidence shows universal action plans improve the management of chronic diseases, such as asthma and diabetes. While many chronic skin diseases, including atopic dermatitis (AD), would benefit from a universal action plan, there are few tools for providers in dermatology.

In a recent study, Collette Utley, DNP, FNC-BC, PNP-BC, and her colleagues address this gap by developing a universal AD care plan called “Your Eczema Action Plan.” A total of 35 providers participated in the study, utilized the care plan in their practice, and responded to questions about their perceptions of the action plan.

Overall, 97% of providers agreed that the care plan improved patient education and 97% would utilize this plan in their practice again. Additionally, 83% of providers reported they were more comfortable treating and educating patients about AD using the “Your Eczema Action Plan,” 71% reported it decreased the amount of time needed to explain therapeutic regimens, and 85% felt it improved patient adherence. Furthermore, 80% of providers reported they would find it helpful if their electronic medical records include the universal action plan.

The use of the “Your Eczema Action Plan” was also associated with improvements in disease management and quality of life among patients.

In an interview with The Dermatologist, Dr Utley discussed her study and its implications for clinical practice.

The Dermatologist: Why did you and your team decide to develop and assess provider’s perceptions of a universal atopic dermatitis care plan?

Dr Utley: During my previous role, I was a medical science liaison in industry. I traveled across the country meeting with dermatologists, and I was able to identify a consistent unmet need, which was the use of care plans in AD.

As a nurse practitioner, I knew that many other chronic diseases, such as asthma, diabetes, arthritis, and chronic obstructive pulmonary disease, have demonstrated effectiveness in management with a care plan.

I sought to identify the need and effectiveness of an AD care plan as a part of my doctoral project. The need was confirmed by the limited data available in the literature on the use of care plans for patients with AD.

The Dermatologist: What is the significance of this and your other findings for clinical practice?

Dr Utley: Overall, this study demonstrated the importance of care plan use in AD and dermatology. We assessed providers’ perceptions of its implementation by evaluating on how the AD care plan tool affected their ability to provide patient education.

The results suggest that patient education, disease management, and quality of life are all improved when they utilize an eczema action plan.

The Dermatologist: What is included in an Eczema Action Plan?

Dr Utley: A good eczema action plan includes information related to the disease, tips on AD triggers to avoid flares, a maintenance plan, active disease state plan, hypoallergenic routine, which should be unbranded, etc.

While I was working as a medical science liaison, I was on the team that helped develop an atopic dermatitis eczema tool called “Your Eczema Action Plan” with Pfizer. This care plan is the one that I use on a daily basis for patients with AD, along with Dr Gold and our team at Gold Skin Care Center. I find it very valuable, especially for newly diagnosed patients.

The Dermatologist: What additional research is needed to support its use and/or improve the development of these action plans for AD?

Dr Utley: Our study had a limited response rate, with only 35 health care providers across the United States. I would love to see the response rate increase in evaluating care plan use in AD and dermatology, in addition to patients’ perceptions on the use of care plans.

Through my research for my doctoral project, I only evaluated providers’ perceptions. In the future, research evaluating patients’ perceptions of care plan use to show the effectiveness of care plan would be needed. There is a shift in the United Kingdom towards self-management with care plan use, and I would like to see that occur in the United States as well.

The Dermatologist: What key takeaways would you like to leave with dermatologists?

Dr Utley: Care plan utilization in AD and dermatology is important to improve patients’ disease management and quality of life. Also, AD care plans can improve the efficiency in delivering education to patients, as well as patient outcomes.

Reference

Utley C, Gold MH, Hall M. Development and evaluation of an atopic dermatitis care plan for providers. J Drugs Dermatol. 2020;19(10): 950-951.