Why does the type of moisturiser matter to a child with eczema? A research nurse’s perspective

 

 

By Sue Davies-Jones, Research Nurse, Faculty of Medicine and Health Sciences, Nottingham University

I have worked as a research nurse at the Centre of Evidence Based Dermatology for 13 years, working on various dermatology research projects. The Best Emollients for Eczema (BEE) study aims to answer the important question of whether some types of emollient (moisturisers) are better than others in the treatment of childhood eczema.

In an ideal world, patients would be able to sample different emollients before deciding which one they preferred, but this is not usually practical. The BEE Trial has been designed to help doctors and patients to decide which types of emollient are best to try first.

GPs are under pressure to prescribe on cost, but we don’t know whether a more watery or cheaper moisturiser is as good as a thicker or more expensive one. Helping families find the “right” moisturiser for them will reduce hassle for the parents and reduce waste from partially used prescriptions.

As a research nurse my job was to recruit participants into the trial, but an important part of this is to make sure that people fully understand what taking part in the trial will mean for them. There was no guarantee which emollient participants would end up with as each participant were allocated by chance to one of the four formulations being used: lotion, cream, gel or ointment.

Most parents were more than happy to try different types of emollient for their children and to take part in the study. However, some (very few) decided not to take part as they were happy with the emollients that they were using now and did not want to risk their child’s skin worsening.

A few participants chose to be seen in GP clinics, but the majority preferred to be seen at home. It allowed families, who might otherwise struggle to fit in a clinic appointment with their busy everyday life to take part.

Baseline visits, where I talked through the study with them, could take up to an hour. I ensured that children were eligible, gave information about the study and what taking part would mean for them and answered any questions parents had. Identifying people who can commit to the full period of the study (a whole year) and who are willing to provide follow-up information throughout is important if the research is to provide a clear answer.

Participants could ask me questions between baseline and 16-week follow-up visit but weren’t allowed to tell me which moisturiser they’ve been given. It was important I did not know which emollient they were using in order that I could assess the skin in a fair and unbiased way. Recruitment finished last year, with the study now in long term follow up.

It’s been especially nice meeting families along the way, who have been so willing to take part in the study, helping us to find out whether there is any one type of moisturiser that is more effective and acceptable as a leave on treatment for eczema.

I am now looking forward to the results which are expected in 2021.

About the Best Emollients for Eczema (BEE) study

The Best Emollients for Eczema (BEE) study is a National Institute for Health Research (NIHR) funded randomised trial, comparing the effectiveness of four types of commonly prescribed emollients for children with eczema (aged between 6 months and 12 years). It aims to offer guidance to parents and clinicians on the most suitable emollient to try first. Results are expected in 2021.

This research was funded by the NIHR Health Technology Assessment (ref 15/130/07). The views expressed are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

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