JMIR Publications

ABSTRACT

Background:

Atopic dermatitis (AD) is a common inflammatory skin disease characterized by dry skin, eczematous lesions, and an often-severe pruritus. The disease may have a negative effect on quality of life and is also associated with symptoms of anxiety and depression. Few individuals with AD receive any form of behavioral intervention. Behavioral interventions for AD are potentially efficacious but need to be constructed so that the intervention is safe, credible, and user-friendly. We have previously reported on a feasibility study that demonstrated that a self-management version of a digital intervention based on cognitive behavior therapy (CBT) for AD can potentially be effective in reducing AD symptoms.

Objective:

The aim of this secondary report was to further examine treatment feasibility and preliminary effects on dermatological quality of life, itching sensations, depressive symptoms, and perceived stress.

Methods:

Twenty-one adults with AD, recruited nationwide in Sweden, were assessed by phone, used the digital intervention for eight weeks and were then assessed by phone again. Participants were also assessed three months after the end of the intervention. There was no therapist-guidance. Feasibility indicators included intervention credibility, usability and possible adverse effects. Other measures included preliminary effects on dermatological quality of life, itching sensations, depressive symptoms and perceived stress.

Results:

The intervention was regarded as credible and no serious adverse events were reported. System usability was however found to be below the pre-determined cutoff for acceptable usability. Preliminary effects at 3-month follow-up were in the moderate to large range for dermatological quality of life (d=.89, 95% CI [0.18, 1.56]), itching sensations (d=.85, 95% CI [0.15, 1.52]), depressive symptoms (d= .78, 95% CI [0.1, 1.45]) and perceived stress (d= .75, 96% CI [0.01, 1.36]).

Conclusions:

An eight-week self-management digital CBT-based intervention was, together with phone calls before and after, a feasible intervention for participants with AD. Preliminary effects were promising and should be explored further in a randomized trial. Intervention usability was, however, rated below cutoff. Efforts should be made to improve written material to increase usability.