New eczema action plan template for GPs

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A team at the University of Bristol has worked with GPs, parents, and children to produce an easy-to-use Written Action Plan (WAP) template for eczema. The 1-page guide to treatment explains when moisturising is required, what to do when the skin becomes red or itchy, and where to seek help if, despite these treatments, the condition is not improving.

Writing in the British Journal of General Practice, the team highlight that treatments for eczema can be complicated, and many parents, and some doctors, have reservations about using topical steroid creams because of concerns about their side-effects.

WAPs have been shown to improve clinical outcomes in asthma. However, only 2 trials of WAPs in eczema have been reported, both of limited methodological quality. Furthermore, eczema WAPs have not been subject to prior developmental work with respect to acceptability, structure, or content.

In a series of interviews with healthcare professionals and parents, the authors of this new study identified a number of challenges to managing eczema included parental confusion about treatment, lack of verbal and written advice from GPs, differing beliefs about the cause and management of eczema, re-prescribing of failed treatments, and a perceived lack of support from GPs.

An eczema WAP was viewed as a tool that could help address these problems. Participants expressed a preference for a WAP that gives clear, individualised guidance on treatment use, presented in a step-up/step-down approach, with general information about eczema, its potential triggers, and how to manage problem symptoms.

Using the information, an eczema WAP was developed which comprises a stepped approach to treatment, eczema essentials, and a parent-completed log of previous treatments and patient preferences. The new WAP will now be tested in practice.