Symptoms of atopic dermatitis (AD), including dry skin, pruritus, and skin lesions, significantly impact the quality of life (QoL) of patients.¹ At the EADV Congress 2024, results from a real-world use of a 12-week digital health program developed to help patients with AD build healthy habits around the itch-scratch cycle, were presented by Dr. Sigrídur Lára Gudmundsdóttir from Sidekick Health, Kopavogur, Iceland.¹

The program, which also provided education, motivation, and support to patients, was available in multiple European countries via patient organizations, healthcare providers’ referrals, and social media.¹ Users logged AD symptoms, severity, and indicators of QoL (energy, sleep, and stress levels) weekly, and were classified into highly- and less-engaged groups using iterative K-means clustering based on active days in-app.¹ Between-group differences in changes for symptoms frequency and severity, and QoL were estimated using mixed models.¹

A total of 639 users were considered activated (active in the program in week two and onwards), of which 327 were included in the analysis (logged symptoms and QoL parameters at least twice).¹ Among these, 180 users were classified as highly engaged (median overall active weeks [Q1, Q3] = 12 [8,14], median overall number of activities [Q1, Q3] = 425 [244, 584]) and 147 users as less engaged (median overall active weeks = 6 [3,9], median overall number of activities = 79 [378, 160]).¹ Across all users, the mean compliance rate of symptoms logging was 62% for the first 12 weeks.¹ At baseline, the 3 most reported symptoms in all users were itching skin (90.2%), rough or dry skin (86.9%), and irritated skin (73.4%), while the 3 most reported triggers were stress (56.6%), scratching (51.4%) and weather (47.1%), with similar rates in both the highly- and less-engaged groups.¹ The mean age of all users was 39.6 years (SD=14.7) and 86.5% were female.¹

Overall, there was a reduction in the total number of symptoms reported (IRRtime = 0.947; 95% CI: 0.936-0.957; p<0.001).¹ The severity of itch, irritated skin, rough/dry skin, and flaking skin were all significantly reduced over 12 weeks.¹ The proportion of users reporting scratching <50% of the time also increased from 16% in week 1 to 50% in week 12 (p<0.001).¹

Highly engaged users experienced a greater reduction in itch symptom severity, with a significant interaction between time and engagement group (p=0.02), suggesting that higher engagement led to greater itch reduction over time.¹ There was a 0.6 point difference in itch severity (reported on a 0-10 scale) between highly- and less-engaged users at week 4 (p=0.03) and a 1.4 point difference at week 12 (p<0.001).¹ Over the 12 weeks, energy levels increased, stress decreased, and sleep quality improved in both groups (all p<0.001), and there was a significant interaction between time and engagement group for sleep quality (p=0.042).¹

In summary, these findings provide real-world evidence that digital health programs can improve symptoms and enhance QoL in individuals with AD, highlighting their potential to transform AD management.¹