Self-Guided vs Clinician-Guided Online Cognitive Behavioral Therapy for Atopic Dermatitis: A Randomized Clinical...

Area of Science:

• Dermatology
• Psychiatry
• Digital Health

Background:

• Clinician-guided online cognitive behavioral therapy (CBT) effectively reduces atopic dermatitis (AD) symptom severity.
• Brief, self-guided online CBT interventions offer potential for cost-effectiveness, easier implementation, and wider patient reach.

Purpose of the Study:

• To determine if a brief, self-guided online CBT intervention is noninferior to a comprehensive, clinician-guided CBT treatment for individuals with AD.

Main Methods:

• A single-blind, randomized clinical noninferiority trial involving adult participants with AD.
• Participants were randomized to either a 12-week self-guided online CBT intervention or a 12-week clinician-guided online CBT intervention.
• The primary outcome measure was the change in the Patient-Oriented Eczema Measure (POEM) score from baseline to 12-week follow-up.

Main Results:

• Both the clinician-guided and self-guided CBT interventions resulted in significant improvements in POEM scores.
• The mean difference in POEM score change between groups was 0.36 points, which was below the predefined noninferiority margin of 3 points.
• No serious adverse events were reported, and clinician time was substantially lower for the self-guided group.

Conclusions:

• A brief, self-guided online CBT intervention is noninferior to clinician-guided CBT for managing atopic dermatitis symptoms.
• The limited resource requirements of self-guided CBT make it a promising strategy for disseminating evidence-based psychological treatments to a broader AD patient population.