Are behavioral interventions a better choice for atopic dermatitis patients? A meta-analysis of 6 randomized controlled trials<sup/>

Zhong, Wenying; Li, Wei; Wu, Guangsheng

doi:10.1016/j.abd.2023.09.004

Acessibilidade / Reportar erro

Brasil

Anais Brasileiros de Dermatologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • An. Bras. Dermatol. 99 (4) • 2024 • https://doi.org/10.1016/j.abd.2023.09.004 copy

Are behavioral interventions a better choice for atopic dermatitis patients? A meta-analysis of 6 randomized controlled trials^☆ ☆ Study conducted at the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background

The treatment for atopic dermatitis (AD) has been the focus of clinical research, and behavioral intervention is considered an indispensable treatment method. To our knowledge, no relevant meta-analysis has evaluated the effects of behavioral interventions on atopic dermatitis.

Objectives

To evaluate the effects of behavioral interventions on atopic dermatitis.

Methods

The authors searched PubMed, EMBASE, and Cochrane CENTRAL to retrieve relevant RCTs (up to Feb 2022). The search strategy involved a combination of related keywords. The Cochrane Q and I² statistics were used to assess heterogeneity.

Results

Six RCTs involving seven reports with 246 patients were included. The results suggested that behavioral interventions could relieve eczema severity (correlation coefficient [r = −0.39]; p < 0.001) and scratching severity significantly (r = −0.19; p = 0.017), while not affect itching intensity (r = −0.02; p = 0.840). A sensitivity analysis confirmed the robustness of the results.

Study limitations

An important limitation of this study was the insufficient number of RCTs and the limited sample size. In addition, the study lacked a control group receiving a type of intervention other than the experimental protocol. Another limitation was the short duration of follow-up.

Conclusions

This study suggests that behavioral interventions could be effective in treating atopic dermatitis by reducing eczema and scratching severity. Additionally, habit-reversal behavioral therapy may be more effective for treating atopic dermatitis.

Keywords
Behavioral therapy; Cognitive behavioral therapy; Dermatitis, atopic; Meta-analysis

Study	Country	Setting	Design	Sample size	Mean age, years	Percent female	Duration of disease	Duration of treatment	Number of sessions	Follow-up	Outcome assessment
Ehlers, et al., 1995	Germany	Clinic-based	UMC	19	22.3	68%	13.8	12 weeks	12	8 weeks	Physician’s evaluation
			DE	27	24.6	60%	15.3
			BT	28	25.4	57%	15.7
			DE + BT	27	25.4	62%	15.2
Habib, et al., 1999	Australia	Population-based	UMC	8	33.0	87%	13.8	6 weeks	6	14 weeks	ADAM
Habib, et al., 1999	Australia	Population-based	BT	9	36.0	78%	17.1	6 weeks	6	14 weeks	ADAM
Melin, et al., 1986	Sweden	Clinic-based	UMC	9	30.5	n.r.	N.R.	4 weeks	2	4 weeks	Physician’s evaluation
Melin, et al., 1986	Sweden	Clinic-based	BT	7	30.5	n.r.	N.R.	4 weeks	2	4 weeks	Physician’s evaluation
Noren, et al., 1989	Sweden	Clinic-based	UMC	22	24.8	64%	N.R.	4 weeks	2	4 weeks	Physician’s evaluation
Noren, et al., 1989	Sweden	Clinic-based	BT	23	24.8	64%	N.R.	4 weeks	2	4 weeks	Physician’s evaluation
Schut, et al., 2013	Germany	Population-based	UMC	14	22.3	71%	N.R.	5 weeks	5	8 weeks	SCORAD
Schut, et al., 2013	Germany	Population-based	BT	14	23.6	71%	N.R.	5 weeks	5	8 weeks	SCORAD
Noren, et al., 2018	Sweden	Population-based	UMC	21	8	72%	8.0	3 weeks	3	8 weeks	SCORAD
Noren, et al., 2018	Sweden	Population-based	BT	18	8	62%	6.0	3 weeks	3	8 weeks	SCORAD

Study	Comparison	Eczema severity	Itching intensity	Scratching severity
Ehlers, et al., 1995a	BT vs. UMC	−0.348 (−0.575 to −0.071)	0.039 (−0.239 to 0.312)	−0.094 (−0.361 to 0.187)
Ehlers, et al., 1995b	DE + BT vs. DE	−0.328 (−0.546 to −0.069)	−0.073 (−0.326 to 0.189)	−0.109 (−0.358 to 0.154)
Habib, et al., 1999	BT vs. UMC	−0.499 (−0.790 to −0.024)	N.R.	N.R.
Melin, et al., 1986	BT vs. UMC	−0.426 (−0.761 to 0.088)	0 (−0.496 to 0.496)	−0.574 (−0.833 to −0.109)
Noren, et al., 1989	BT vs. UMC	−0.346 (−0.581 to −0.058)	N.R.	−0.248 (−0.505 to 0.049)
Schut, et al., 2013	BT vs. UMC	−0.272 (−0.586 to 0.113)	N.R.	N.R.
Noren, et al., 2018	BT vs. UMC	−0.518 (−0.721 to −0.233)	N.R.	−0.059 (−0.354 to 0.246)

Sociedade Brasileira de Dermatologia Av. Rio Branco, 39 18. and., 20090-003 Rio de Janeiro RJ, Tel./Fax: +55 21 2253-6747 - Rio de Janeiro - RJ - Brazil
E-mail: revista@sbd.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] * Corresponding author. E-mail:sczjhzzwy@126.com (W. Zhong)

Brasil

Brasil

Are behavioral interventions a better choice for atopic dermatitis patients? A meta-analysis of 6 randomized controlled trials☆ ☆ Study conducted at the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China.

Abstract

Background

Objectives

Methods

Results

Study limitations

Conclusions

Are behavioral interventions a better choice for atopic dermatitis patients? A meta-analysis of 6 randomized controlled trials^☆ ☆ Study conducted at the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China.