Prevention of hand eczema: effect of an educational program versus treatment as usual - results of the randomized clinical PREVEX trial
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Prevention of hand eczema : effect of an educational program versus treatment as usual - results of the randomized clinical PREVEX trial. / Fisker, Maja H; Ebbehøj, Niels E; Vejlstrup, Søren Grove; Lindschou, Jane; Gluud, Christian; Winkel, Per; Bonde, Jens Peter; Agner, Tove.
In: Scandinavian Journal of Work, Environment & Health, Vol. 44, No. 2, 2018, p. 212-218.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Prevention of hand eczema
T2 - effect of an educational program versus treatment as usual - results of the randomized clinical PREVEX trial
AU - Fisker, Maja H
AU - Ebbehøj, Niels E
AU - Vejlstrup, Søren Grove
AU - Lindschou, Jane
AU - Gluud, Christian
AU - Winkel, Per
AU - Bonde, Jens Peter
AU - Agner, Tove
PY - 2018
Y1 - 2018
N2 - Objective Occupational hand eczema has adverse health and socioeconomic impacts for the afflicted individuals and society. Prevention and treatment strategies are needed. This study aimed to assess the effectiveness of an educational intervention on sickness absence, quality of life and severity of hand eczema. Methods PREVEX (PreVention of EXema) is an individually randomized, parallel-group superiority trial investigating the pros and cons of one-time, 2-hour, group-based education in skin-protective behavior versus treatment as usual among patients with newly notified occupational hand eczema, with follow-up after one year. Co-primary outcomes were total sickness absence, health-related quality of life (HR-QoL), and self-reported severity of hand eczema. Results Patients (N=1668) with notified occupational skin diseases from July 2012 to November 2014 were invited to participate in the trial. Of these, 756 were randomized to the intervention (N= 376) versus control (N=380) group. The intervention group had 21% fewer sickness absence days compared with the control group [95% confidence interval (CI) -55-40%, P=0.43]. We found no significant difference in the change of HR-QoL for the intervention compared with the control group (4% lower in the intervention group, 95% CI -18-13%, P=0.67). The ordinal odds of scoring worse on self-reported hand eczema severity was 15% lower in the intervention compared with the control group (95% CI -39-18%, P=0.34). Post-hoc sub-group analyses indicated that the effect of the intervention on severity differed between occupations, being detrimental to healthcare workers and beneficial in all other occupations. Conclusion The educational skincare program had no marked effect on the primary outcomes sickness absence, HR-QoL, and severity of hand eczema when compared with treatment as usual.
AB - Objective Occupational hand eczema has adverse health and socioeconomic impacts for the afflicted individuals and society. Prevention and treatment strategies are needed. This study aimed to assess the effectiveness of an educational intervention on sickness absence, quality of life and severity of hand eczema. Methods PREVEX (PreVention of EXema) is an individually randomized, parallel-group superiority trial investigating the pros and cons of one-time, 2-hour, group-based education in skin-protective behavior versus treatment as usual among patients with newly notified occupational hand eczema, with follow-up after one year. Co-primary outcomes were total sickness absence, health-related quality of life (HR-QoL), and self-reported severity of hand eczema. Results Patients (N=1668) with notified occupational skin diseases from July 2012 to November 2014 were invited to participate in the trial. Of these, 756 were randomized to the intervention (N= 376) versus control (N=380) group. The intervention group had 21% fewer sickness absence days compared with the control group [95% confidence interval (CI) -55-40%, P=0.43]. We found no significant difference in the change of HR-QoL for the intervention compared with the control group (4% lower in the intervention group, 95% CI -18-13%, P=0.67). The ordinal odds of scoring worse on self-reported hand eczema severity was 15% lower in the intervention compared with the control group (95% CI -39-18%, P=0.34). Post-hoc sub-group analyses indicated that the effect of the intervention on severity differed between occupations, being detrimental to healthcare workers and beneficial in all other occupations. Conclusion The educational skincare program had no marked effect on the primary outcomes sickness absence, HR-QoL, and severity of hand eczema when compared with treatment as usual.
KW - Adult
KW - Dermatitis, Occupational/prevention & control
KW - Eczema
KW - Female
KW - Hand
KW - Health Personnel
KW - Humans
KW - Male
KW - Middle Aged
KW - Patient Education as Topic
KW - Quality of Life
KW - Self Report
KW - Severity of Illness Index
KW - Sick Leave/statistics & numerical data
KW - Surveys and Questionnaires
U2 - 10.5271/sjweh.3687
DO - 10.5271/sjweh.3687
M3 - Journal article
C2 - 29493714
VL - 44
SP - 212
EP - 218
JO - Scandinavian Journal of Work, Environment & Health
JF - Scandinavian Journal of Work, Environment & Health
SN - 0355-3140
IS - 2
ER -
ID: 217937046