Emollients, education and quality of life: the RCPCH care pathway for children with eczema
- Helen Cox1,
- Kate Lloyd2,
- Hywel Williams3,
- Peter D Arkwright4,
- Trevor Brown5,
- Christine Clark6,
- Margaret Campbell7,
- Claudia Gore1,
- Catherine Hardman1,
- Andrew Langford8,
- Sue Lewis-Jones9,
- Sandra Lawton3,
- Matthew Ridd10,
- Lucia Russell11,
- Dalbir Sohi12,
- Rosemary Turnbull13,
- Carina Venter14,
- John O Warner15 on behalf of the Science and Research Department, Royal College of Paediatrics and Child Health
- 1Department of Paediatrics, Imperial College Healthcare Trust, St Mary's Hospital, London, UK
- 2Science and Research Department, Royal College of Paediatrics and Child Health, London, UK
- 3Department of Dermatology, Nottingham University Hospitals NHS Trust, Nottingham, UK
- 4Manchester Children's University Hospital NHS Trust, Greater Manchester, UK
- 5The Ulster Hospital, Belfast, UK
- 6Independent Pharmaceutical Consultant and Chair of Skin Care Campaign
- 7NHS Wirral, Merseyside, UK
- 8CEO, Skin Care Campaign, Leeds, UK
- 9Department of Dermatology, Ninewells Hospital and Medical School, Dundee, UK
- 10School of Social and Community Medicine, University of Bristol, Bristol, UK
- 11Newcastle General Hospital, City Centre, UK
- 12Paediatric Department, North Middlesex University Hospital NHS Trust, London, UK
- 13Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
- 14School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK
- 15Department of Paediatrics, Imperial College, St Mary's Hospital Campus, London, UK
- Correspondence to Dr Helen Cox, Department of Paediatrics, Imperial College Healthcare Trust, London SW7 2AZ, UK;
- Accepted 21 July 2011
Objectives The Royal College of Paediatrics and Child Health (RCPCH) Science and Research Department was commissioned by the Department of Health to develop national care pathways for children with allergies. The eczema pathway focuses on defining the competences to improve the equity of care received by children with eczema.
Method The eczema pathway was developed by a multidisciplinary working group and was based on a comprehensive review of evidence. The pathway was reviewed by a broad group of stakeholders including paediatricians, allergists, dermatologists, specialist nurses, dietician, patients' representatives and approved by the Allergy Care Pathways Project Board and the RCPCH Clinical Standards Committee. It was also reviewed by a wide range of stakeholders.
Results The results are presented in three sections: the evidence review, mapping and the core knowledge document. The various entry points to the ideal pathway of care are defined from self-care through to follow-up. There is considerable emphasis on good skin care and when allergy problems should be dealt with. The pathway algorithm and associated competences can be downloaded from http://www.rcpch.ac.uk/allergy/eczema.
Conclusions Effective eczema management is holistic and encompasses an assessment of severity and impact on quality of life, treatment of the inflamed epidermal skin barrier, recognition and treatment of infection and assessment and management of environmental and allergy triggers. Patient and family education which seeks to maximise understanding and concordance with treatment is also important in all children with eczema.
Competing interests JW: Novartis, Danone, Airsonette, Merck, Allergy Therapeutics, Phadia. Research, GSK, Astra–Zeneca, Merck, Allergy Therapeutics, ALK. TB: MSD-UK, GSK, ALK-Abello, Mead Johnson, Danone (Nutricia), Astra–Zeneca, Allergy NI, Schering Plough. CC: Stiefel, Galderma, Almirall. Conference attendance: Leo, Galderma. AL: Stiefel, GSK, Reckitt Benckiser, Dermal, Leo, Galderma. SLJ: Wyeth, Astellas, Stiefel. Chair, NICE guildeline for atopic eczema in children. CV: GlaxoSmithKline, Danone, Mead Johnson.
Provenance and peer review Commissioned; internally peer reviewed.