Positive change in hand care habits using therapeutic patient education in chronic hand eczema

Contact Dermatitis. 2020 Jan;82(1):10-17. doi: 10.1111/cod.13390. Epub 2019 Oct 7.

Abstract

Background: Chronic hand eczema (CHE) is a major burden for patients. Maintenance treatment involves prevention measures limiting detrimental behaviour and aggravating factors.

Objective: To evaluate the effect of a standardised care program including therapeutic patient education (TPE) on hand care behaviours, clinical severity, quality of life, and work productivity.

Methods: A single-centre study was conducted prospectively. Together with the prescription of a topical steroid, patients participated in individual TPE sessions. Evaluations were performed initially and repeated three months after the therapeutic intervention. They included a structured analysis of hand care behaviours, the assessment of the mTLSS (modified Total Lesion Symptom Score), DLQI (Dermatology Life Quality Index), and WPAI (Work Productivity and Activity Impairment).

Results: Seventy-one patients were included (30 men, 42.3%). Three months after completion of the standardised care program, hand care behaviours such as hand washing and rinsing, hand drying, wearing protective gloves, using moisturizing creams, and following specific treatments and recommendations for CHE improved significantly in the 58 patients who completed the study and were associated with a significant improvement in the mTLSS, DLQI, and WPAI scores.

Conclusions: TPE helps patients change their hand care behaviours and adopt skin protection measures, and may improve CHE severity, quality of life, and work productivity.

Keywords: chronic hand eczema; hand care behaviours; skin protection; therapeutic patient education.

Publication types

  • Clinical Trial

MeSH terms

  • Administration, Cutaneous
  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Anti-Inflammatory Agents / therapeutic use*
  • Chronic Disease
  • Combined Modality Therapy
  • Eczema / diagnosis
  • Eczema / psychology
  • Eczema / therapy*
  • Efficiency
  • Female
  • Follow-Up Studies
  • Hand Dermatoses / diagnosis
  • Hand Dermatoses / psychology
  • Hand Dermatoses / therapy*
  • Hand Hygiene / methods*
  • Health Behavior*
  • Health Status Indicators
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic / methods*
  • Prospective Studies
  • Quality of Life
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents