Improving Outcomes and Quality of Life for Patients With Hand and Foot Eczema: Randomized Study of a Patient-Centered Monitoring App
BackgroundHand and foot eczema is a frequent chronic dermatological condition. The persistent itching, pain, and blistering can impair hand and foot function, leading to difficulties in performing tasks requiring fine motor skills. In addition, the impact on the quality of li...
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JMIR Publications
2025-01-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e52159 |
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| author | Aimee Bruch Wanja Weigandt Yannic Schardt Raphael Herr Johannes Benecke Astrid Schmieder |
| author_facet | Aimee Bruch Wanja Weigandt Yannic Schardt Raphael Herr Johannes Benecke Astrid Schmieder |
| author_sort | Aimee Bruch |
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BackgroundHand and foot eczema is a frequent chronic dermatological condition. The persistent itching, pain, and blistering can impair hand and foot function, leading to difficulties in performing tasks requiring fine motor skills. In addition, the impact on the quality of life for affected patients is significant, as the symptoms can be extremely uncomfortable and disruptive to daily activities. By incorporating digital health apps and educational programs into the management of hand and foot eczema, patients may receive ongoing support, optimize their clinical outcomes, and ultimately enhance their overall quality of life.
ObjectiveThe purpose of this study was to evaluate the effect of a smartphone app combined with educational training on the clinical outcomes and mental health of patients with chronic hand and foot eczema during a 60-week study period.
MethodsPatients in the intervention group participated in an educational program focused on chronic hand and foot eczema at baseline and had in-person visits at weeks 0, 12, 24, 36, and 60, as well as access to our study smartphone app. The app allowed patients to upload pictures of their hands and feet and answer questions about pain severity, itching, mood, and quality of life. A chat function was also available for patients to contact their dermatologist. The control group received only the in-person study visits described above.
ResultsA total of 87 patients were included in the study and randomized to the intervention (n=43) or control (n=44) groups. In total, 23 patients from the intervention group and 34 patients from the control group completed the study. Throughout the 60-week study period, a significant reduction in Hand Eczema Severity Index (HECSI) was consistently observed in all patients (week 60: linear regression coefficient [Coef]=–1.108; P≤.001). A trend toward a greater improvement of the HECSI in the intervention group compared to the control group was noticed (week 60: Coef=0.597; P=.05). Subgroup analysis revealed that patients who used the app with a usage frequency of less than 20% demonstrated a significant reduction in the HECSI from week 0 to week 60 (week 60: Coef=–1.275; P=.04) and a significant reduction in the Dermatology Life Quality Index (week 60: Coef=–1.246; P=.04) compared to the control group. We were able to demonstrate a significant correlation between the HECSI calculated based on pictures uploaded by patients through the app and the HECSI assessed during personal visits (ρ=0.885; P<.001), despite the potentially lower image quality of the pictures uploaded through the app.
ConclusionsThis study provides further evidence that digital health apps can provide valuable support in improving patient clinical outcomes and management, especially as the app-based assessment of hand and feed images appears to be reliable.
Trial RegistrationDeutsches Register Klinischer Studien DRKS00020963; https://drks.de/search/de/trial/DRKS00020963 |
| format | Article |
| id | doaj-art-7845e0d4d6be419f9c528528f3dfbd65 |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
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| series | Journal of Medical Internet Research |
| spelling | doaj-art-7845e0d4d6be419f9c528528f3dfbd652025-01-21T18:00:37ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-01-0127e5215910.2196/52159Improving Outcomes and Quality of Life for Patients With Hand and Foot Eczema: Randomized Study of a Patient-Centered Monitoring AppAimee Bruchhttps://orcid.org/0000-0002-0986-0408Wanja Weigandthttps://orcid.org/0000-0002-3737-4087Yannic Schardthttps://orcid.org/0000-0002-8445-7053Raphael Herrhttps://orcid.org/0000-0003-0079-2792Johannes Beneckehttps://orcid.org/0000-0003-1792-9361Astrid Schmiederhttps://orcid.org/0000-0002-6421-9699 BackgroundHand and foot eczema is a frequent chronic dermatological condition. The persistent itching, pain, and blistering can impair hand and foot function, leading to difficulties in performing tasks requiring fine motor skills. In addition, the impact on the quality of life for affected patients is significant, as the symptoms can be extremely uncomfortable and disruptive to daily activities. By incorporating digital health apps and educational programs into the management of hand and foot eczema, patients may receive ongoing support, optimize their clinical outcomes, and ultimately enhance their overall quality of life. ObjectiveThe purpose of this study was to evaluate the effect of a smartphone app combined with educational training on the clinical outcomes and mental health of patients with chronic hand and foot eczema during a 60-week study period. MethodsPatients in the intervention group participated in an educational program focused on chronic hand and foot eczema at baseline and had in-person visits at weeks 0, 12, 24, 36, and 60, as well as access to our study smartphone app. The app allowed patients to upload pictures of their hands and feet and answer questions about pain severity, itching, mood, and quality of life. A chat function was also available for patients to contact their dermatologist. The control group received only the in-person study visits described above. ResultsA total of 87 patients were included in the study and randomized to the intervention (n=43) or control (n=44) groups. In total, 23 patients from the intervention group and 34 patients from the control group completed the study. Throughout the 60-week study period, a significant reduction in Hand Eczema Severity Index (HECSI) was consistently observed in all patients (week 60: linear regression coefficient [Coef]=–1.108; P≤.001). A trend toward a greater improvement of the HECSI in the intervention group compared to the control group was noticed (week 60: Coef=0.597; P=.05). Subgroup analysis revealed that patients who used the app with a usage frequency of less than 20% demonstrated a significant reduction in the HECSI from week 0 to week 60 (week 60: Coef=–1.275; P=.04) and a significant reduction in the Dermatology Life Quality Index (week 60: Coef=–1.246; P=.04) compared to the control group. We were able to demonstrate a significant correlation between the HECSI calculated based on pictures uploaded by patients through the app and the HECSI assessed during personal visits (ρ=0.885; P<.001), despite the potentially lower image quality of the pictures uploaded through the app. ConclusionsThis study provides further evidence that digital health apps can provide valuable support in improving patient clinical outcomes and management, especially as the app-based assessment of hand and feed images appears to be reliable. Trial RegistrationDeutsches Register Klinischer Studien DRKS00020963; https://drks.de/search/de/trial/DRKS00020963https://www.jmir.org/2025/1/e52159 |
| spellingShingle | Aimee Bruch Wanja Weigandt Yannic Schardt Raphael Herr Johannes Benecke Astrid Schmieder Improving Outcomes and Quality of Life for Patients With Hand and Foot Eczema: Randomized Study of a Patient-Centered Monitoring App Journal of Medical Internet Research |
| title | Improving Outcomes and Quality of Life for Patients With Hand and Foot Eczema: Randomized Study of a Patient-Centered Monitoring App |
| title_full | Improving Outcomes and Quality of Life for Patients With Hand and Foot Eczema: Randomized Study of a Patient-Centered Monitoring App |
| title_fullStr | Improving Outcomes and Quality of Life for Patients With Hand and Foot Eczema: Randomized Study of a Patient-Centered Monitoring App |
| title_full_unstemmed | Improving Outcomes and Quality of Life for Patients With Hand and Foot Eczema: Randomized Study of a Patient-Centered Monitoring App |
| title_short | Improving Outcomes and Quality of Life for Patients With Hand and Foot Eczema: Randomized Study of a Patient-Centered Monitoring App |
| title_sort | improving outcomes and quality of life for patients with hand and foot eczema randomized study of a patient centered monitoring app |
| url | https://www.jmir.org/2025/1/e52159 |
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