Psychological and educational interventions for atopic eczema in children. [Cochrane Review]

Atopic eczema is an itchy inflammatory skin condition which affects the quality of life of children with eczema and their parents; it can affect up to 15% of school children in the UK. Psychological and educational approaches to treating eczema have been used to complement medication in managing eczema by, for example, promoting relaxation and educating parents and children to understand the condition and their role in its successful management. However, the effectiveness of these approaches has not been systematically reviewed. The main finding of the review is that there is currently only limited research evidence about the effectiveness of educational and psychological approaches when used with medicines for the treatment of childhood eczema. We were only able to include one study on the effectiveness of psychological approaches in the review. We included four educational studies, of which three identified that education decreased the severity of the eczema, and one study found that education improved quality of life for parents of children with eczema. Relaxation methods reduced the severity of the eczema, compared to discussion only, in the psychological study. Two different approaches have been used to deliver education; one led by a nurse and the other by a team of health professionals. Due to weaknesses in the quality of most of the research studies and the fact that different measures were used to evaluate effectiveness of the approaches, we cannot draw strong conclusions about whether psychological and educational approaches work or which is the best approach to use. More details are needed about the psychological and educational approaches used, to allow a greater understanding of the key factors that might help reduce eczema. Better description of the research methods used are also needed. Research priority should also be given to comparing the relative cost effectiveness of health professionals educating parents either in teams or by nurses alone. No adverse effects have been reported. Limitations of the review: We were able to find only five studies eligible for inclusion in the review and we were not able to combine findings from these studies due to the different ways in which effectiveness of the approaches were measured