Education to improve quality of life of people with chronic inflammatory skin conditions: a systematic review of the evidence.

Patient and carer education has been proposed as a way of improving health-related quality of life (HRQoL) among people with chronic inflammatory skin conditions. This systematic review aimed to assess the effects of education which specifically addresses HRQoL among people with chronic inflammatory skin conditions. We searched 12 literature databases and other sources (to July 2014). Seven randomised controlled trials (RCTs) met the review inclusion criteria, from which data were extracted and critically appraised. Two RCTs showed that for psoriasis in adults, group-based and text message education (as adjuncts to usual care), respectively, resulted in better HRQoL and disease severity outcomes than comparators. One RCT found group-based education for children with eczema (atopic dermatitis) and their parents resulted in greater improvements in parents’ HRQoL and the children's disease severity than no education at 12 months. The remaining RCTs evaluated an educational session for psoriasis, a website for carers of children with eczema, information on skin care and make-up use given to women with acne, and an itch coping programme for a range of conditions, all as adjuncts to usual care. None found statistically significant effects on HRQoL or disease severity compared to usual care. Common features of the effective interventions were long delivery (over 6 weeks to three months) and delivery by a multi-disciplinary team. Overall, the evidence base is currently limited and generally of an unclear risk of bias. There is a need for more large RCTs evaluating piloted and theory-based interventions.