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Open Access Highly Accessed Study protocol

Chronic hand eczema - self-management and prognosis: a study protocol for a randomised clinical trial

Annette Mollerup1*, Niels Kren Veien2 and Jeanne Duus Johansen1

Author affiliations

1 National Allergy Research Centre, Copenhagen University Hospital Gentofte, Gentofte, Denmark

2 The Dermatological practice at Vesterbro, Aalborg, Denmark

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Citation and License

BMC Dermatology 2012, 12:6  doi:10.1186/1471-5945-12-6

Published: 12 June 2012

Abstract

Background

Hand eczema has a one-year prevalence of approximately 10 % in the general Danish population. Often the disease becomes chronic with numerous implications for the individual’s daily life, occupation and quality of life. However, no guidelines of self-management recommendations beyond the acute stage are given. Self-management of the disease is pivotal and involves self-monitoring of the condition, medication adherence, and preventive behaviour. Interventions best to support the individual in this ongoing process need to be developed.

Methods/design

This paper describes the design of a randomised clinical trial to test a newly developed intervention of individual counselling versus conventional information. 300 patients consecutively referred to dermatologic treatment at two different settings are individually randomised to either the intervention programme, named ‘The Healthy Skin Clinic’ or to the control group. Block-wise randomisation according to setting and gender is carried out.

The intervention offers a tool for self-monitoring; basic and specific individual counselling; the possibility of asynchronous communication with the intervention team; and an electronic patient dialogue forum. Primary outcome variable is objective assessment of the hand eczema severity performed at baseline prior to randomisation, and repeated at six months follow-up. Secondary outcome variables are dermatology related life quality and perceived global burden of disease.

Discussion

The trial aims at evaluating a newly developed guidance programme which is expected to support self-management of patients referred to dermatology treatment due to chronic hand eczema. The design of the protocol is pragmatic with blinding of neither participants nor the investigator. Thus, in the interpretation of the results, the investigator takes into account effects that may be attributed to actors of the interventions rather than the intervention per se as well of potential observer bias. Inclusion criterions are wide in order to increase transferability of the results.

Trial registration

The trial is registered in ClinicalTrials.Gov with registration number NCT01482663.

Keywords:
Chronic hand eczema; Protocol for Self-management intervention; Randomised clinical trial; Patient counselling; The Healthy Skin Clinic; Nurse-led consultation