Digital Eczema Education Decreases Relapse Rates in Children in the Short-Term

A smartphone-based patient-caregiver eczema education intervention may help to reduce short-term disease relapse risk among young children with moderate-to-severe atopic dermatitis, a new study suggests.1

Despite this conclusion, the study also suggests effects of this intervention may diminish beyond 12 weeks of use. This analysis was authored by such investigators as Huan Yang, MD, PhD, of the Children’s Hospital of Chongqing Medical University’s Department of Dermatology. Through their work, Yang et al sought to investigate whether implementing a smartphone-based patient-caregiver educational program could lower eczema relapse rates in children aged 0 - 6 years.

The investigators highlighted the paradigm shift, resulting from the COVID-19 pandemic, toward a willingness among caregivers to utilize digital health tools.2 Consequently, a smartphone-based intervention was explored among this patient population.

“In this multicenter, randomized controlled trial (RCT), we aim to assess the efficacy of a smartphone-based digital educational program in comparison to conventional outpatient consultation alone on the relapse rates of [atopic dermatitis],” Yang and coauthors wrote.1

Study Design Details

The investigative team’s research was conducted within pediatric dermatology clinics located at 12 tertiary public hospitals across China. Their study involved a multi-center, parallel-group randomized controlled trial design (ChiCTR2000031474). Children between birth and 6 years of age with an atopic dermatitis diagnosis were recruited by the team in alignment with the American Academy of Dermatology Consensus criteria.

Patients were required, in order to be eligible for inclusion, to have moderate-to-severe atopic dermatitis. This was defined by Yang et al as a SCORAD score of 25 at minimum and an Investigator’s Global Assessment score of 3 or greater. A requirement was also in place necessitating a child’s primary caregiver as being both able to read Chinese and to operate a smartphone. They identified such patients during routine in-person outpatient visits.

The majority of those labeled as caregivers were parents, though grandparents made up a small proportion of the study subjects. Children recruited for the analysis were randomly placed into a 1:1 ratio, either in the intervention arm who received a smartphone-based digital education program in addition to usual care, or the study’s control arm, receiving standard outpatient consultation by itself.

A computer-generated sequence with a block size of 4 was used for the purposes of randomization. The study’s digital educational protocol was developed and managed via the oversight of an independent clinical research organization through a secure cloud-based system. This organization was separate from Yang and colleagues’ team of investigators.

Using a WeChat app-based Skin Care E-Station platform for its delivery, the intervention involved a 12-week program. The intervention’s content included structured educational modules in multimedia formats, with interactive learning tools and an electronic action plan personalized and adjusted for the child’s age and the severity of their eczema. The study’s main outcome measure was the rate of relapses at the 12-week mark following completion of acute treatment.

In their study’s secondary outcomes, Yang and coauthors looked at any shifts in disease severity, evaluated via the Scoring Atopic Dermatitis index, the Patient-Oriented Eczema Measure, and the Peak Pruritus Numerical Rating Scale. They also examined participants’ health-related quality of life using the Children’s Dermatology Life Quality Index or Infant’s Dermatitis Quality of Life Index and the Dermatitis Family Impact questionnaire. Follow-up interactions with participants extended to 52 weeks.

Results After Using Digital Eczema Education Tool

There were 615 children randomized, and the participants had a mean age of 3.3 years (SD 1.7).1 51.5% of the study subjects were listed as male. Relapses at the 12-week mark took place significantly less often in the digital education cohort versus the control cohort. Specifically, Yang and colleagues found relapses occurred in 16.6% versus 24.0% of those evaluated, respectively (relative risk 0.69, 95% CI 0.50–0.96; P = .02).

In their Kaplan–Meier analysis, Yang et al observed improved relapse-free survival within the initial 100 days in subjects given the digital intervention (hazard ratio 0.688, 95% CI 0.490–0.966; P = .03).1 There was no statistically significant difference seen between study arms in terms of relapse rates beyond 12 weeks or for secondary outcome measures. The team’s data regarding usage indicated strong engagement with the digital intervention. Specifically, they found 58.0% of caregivers continued to access this digital platform on a regular basis each week.

“Our findings are consistent with prior evidence demonstrating that structured education improves short-term management and adherence in pediatric [atopic dermatitis],” the investigative team concluded.1 “However, they also highlight a common challenge: achieving long-term disease modulation with brief interventions is difficult.”

References

1. Yang H, Shu H, Wang H, et al. Smartphone-Based Digital Eczema Education Program for Atopic Dermatitis in Children Aged 0 to 6 Years: Multicenter, Randomized, Parallel Controlled Clinical Study. J Med Internet Res. 2026 Jan 7;28:e79559. doi: 10.2196/79559. PMID: 41499674; PMCID: PMC12779099.

2. Golinelli D, Boetto E, Fantini MP, et al. Adoption of Digital Technologies in Health Care During the COVID-19 Pandemic: Systematic Review of Early Scientific Literature. J Med Internet Res. 2020 Nov 6;22(11):e22280. doi: 10.2196/22280. PMID: 33079693; PMCID: PMC7652596.