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New eczema ‘written action plan’ developed to help parents manage their child’s eczema

5 December 2017

Researchers from the University of Bristol’s Centre for Academic Primary Care have developed an eczema written action plan (the eWAP) to help parents manage their child’s eczema at home. The plan, completed by parents with their GP, will help parents decide what treatments to use or when to contact their family doctor, depending on the severity of their child’s symptoms.

Eczema causes dry and itchy skin and affects one in five children in the UK. Treatment regimes for children with eczema are time consuming and can be confusing in terms of what to do when and how to apply treatments. As a result, treatment adherence is often poor. If treatments are not applied correctly, the eczema can worsen and affect the quality of life of the child and their family.

Written action plans (WAPs) are a set of instructions, specific to a patient, on how to look after their condition. They have been successful in the treatment of asthma, another long-term condition that is common in children.

The research team, led by Dr Matthew Ridd, developed the tool as part of a study in which they explored, with parents and health professionals, the potential of a WAP for improving treatment adherence in childhood eczema. The study, published in the British Journal of General Practice today, identified several challenges that the eWAP has been designed to address, including:

  • parental confusion about treatment application
  • lack of verbal and written advice from GPs
  • differing beliefs about the cause and management of eczema
  • re-prescribing or failed treatments
  • parents feeling unsupported by their GPs.

Dr Ridd said: “Both parents and healthcare professionals thought a WAP for eczema was a good idea and would help address the challenges identified in our study. Although GPs had some concerns about fitting it in with other competing priorities, there was general agreement that it could be a useful educational tool, increasing parents’ knowledge and confidence in managing eczema at home, and possibly reducing consultations.

“We have made the eWAP freely available to parents, doctors and nurses for clinical use and would like to encourage interested parents and clinicians to download it, use it and let us know how they get on. We have tried to make it as user-friendly as possible, using pictures and a colourful design to make it easy to use and understand. The next step for the research team is to evaluate the WAP,  possibly in a clinical trial, to see if it leads to better controlled eczema when used by families.”

The eWAP is available in Word and PDF formats from It includes a section for individualised guidance on treatment, using a simple stepped approach, and general information about eczema, its potential triggers and how to manage problem symptoms. It also provides links to useful resources, such as videos which show how to apply moisturisers correctly.

Further information

Paper: ‘Developing a written action plan for children with eczema: a qualitative study’ by Kingsley Powell, Emma Le Roux, Matthew Ridd and Jon Banks. Published in British Journal of General Practice (early online version). December 2017.

More information about how the EWAP was developed is available from the Action Plans for Children with Eczema (APACHE) website.

The research was funded by grants from the National Institute for Health Research (NIHR: PDF-2014-07-013), Elizabeth Blackwell Institute for Health Research, University of Bristol, the Wellcome Trust Institutional Strategic Support Fund, and Avon Primary Care Research Collaborative (APCRC).

About the Centre for Academic Primary Care

The Centre for Academic Primary Care (CAPC) is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching. Follow on Twitter: @capcbristol.

About the NIHR

The National Institute for Health Research (NIHR): improving the health and wealth of the nation through research. Established by the Department of Health, the NIHR:

• funds high quality research to improve health

• trains and supports health researchers

• provides world-class research facilities

• works with the life sciences industry and charities to benefit all

• involves patients and the public at every step.

For further information, visit the NIHR website

The views expressed in this release are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health.

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