Continuous treatment strategies improve psychological status and quality of life in patients with atopic dermatitis

Table 1 Demographic and baseline characteristics, n (%)

Characteristic	Intervention group (n = 60)	Control group (n = 60)	P value
Age (years), mean ± SD	42.3 ± 11.2	41.8 ± 10.9	0.78
Gender (female/male)	34/26 (56.7)	33/27 (55.0)	0.83
Disease duration (years), mean ± SD	8.4 ± 3.6	8.2 ± 3.8	0.82
BMI (kg/m2), mean ± SD	24.5 ± 3.2	24.8 ± 3.5	0.67
Smoking history	15 (25.0)	18 (30.0)	0.56
Alcohol consumption	10 (16.7)	12 (20.0)	0.78
Education level	30 (50.0)	32 (53.3)	0.67
Comorbid hypertension	18 (30.0)	20 (33.3)	0.72
Comorbid diabetes mellitus	12 (20.0)	14 (23.3)	0.68
Family history of cardiovascular disease	10 (16.7)	11 (18.3)	0.85
Baseline systolic blood pressure (mmHg), mean ± SD	125 ± 15	127 ± 16	0.69
Baseline diastolic blood pressure (mmHg), mean ± SD	80 ± 10	81 ± 11	0.74
Baseline heart rate (beats/minute), mean ± SD	75 ± 10	76 ± 11	0.80

BMI: Body mass index.

Table 2 Clinical symptom improvement, mean ± SD

Indicator	Intervention group (n = 60)	Control group (n = 60)	P value
Mean severity score at baseline	18.6 ± 4.2	18.4 ± 4.1	0.85
Mean severity score at 12 months	7.3 ± 2.8	11.2 ± 3.5	< 0.001
Reduction in severity score	11.3 ± 3.5	7.2 ± 3.2	< 0.001
Disease recurrence rate (%)	15.0	35.0	< 0.01
Duration of acute flares (days)	4.2 ± 1.5	7.8 ± 2.3	< 0.001
QoL	85 ± 10	75 ± 12	< 0.05
Symptom improvement rate (%)	80.0	50.0	< 0.001
Patient satisfaction score (%)	90.0	70.0	< 0.001
Frequency of acute flares (times/month)	0.5 ± 0.3	1.2 ± 0.5	< 0.001
Medication use reduction (%)	60.0	30.0	< 0.001
Sleep quality score	80 ± 10	70 ± 12	< 0.05
Physical activity level (MET-min/week)	1500 ± 300	1000 ± 200	< 0.05

QoL: Quality of life score; MET: Metabolic equivalent of task.

Table 3 Quality of life outcomes, mean ± SD

Indicator	Intervention group (n = 60)	Control group (n = 60)	P value
Mean DLQI score at baseline	16.8 ± 3.9	16.5 ± 3.8	0.76
Mean DLQI score at 12 months	5.2 ± 2.1	9.6 ± 2.8	< 0.001
Reduction in DLQI score	11.6 ± 3.2	6.9 ± 2.9	< 0.001
Percentage of patients with DLQI ≤ 5 at 12 months (%)	75	45	< 0.001
Additional indicators
SF-36 PCS	80 ± 10	70 ± 12	< 0.05
SF-36 MCS	82 ± 11	72 ± 13	< 0.05
EQ-5D health state score	0.85 ± 0.10	0.75 ± 0.12	< 0.05
Pain interference score (0-10 scale)	2.0 ± 1.0	4.0 ± 1.5	< 0.001

DLQI: Dermatology life quality index; PCS: Physical component score; MCS: Mental component score; SF-36: Short form-36 health survey; EQ-5D: EuroQol 5-dimension.

Table 4 Social functioning assessment, mean ± SD

Indicator	Intervention group (n = 60)	Control group (n = 60)	P value
Mean total SDSS score at baseline	7.2 ± 1.8	7.1 ± 1.9	0.81
Mean total SDSS score at 12 months	2.8 ± 1.1	4.5 ± 1.4	< 0.001
Reduction in total SDSS score	4.4 ± 1.5	2.6 ± 1.3	< 0.001
Percentage of patients with improved social engagement (%)	82	55	< 0.001
Social activities score	3.0 ± 1.0	5.0 ± 1.2	< 0.001
Interpersonal relationships score	2.5 ± 1.0	4.0 ± 1.3	< 0.001
Work performance score	2.8 ± 1.1	4.2 ± 1.4	< 0.001
Family life score	2.7 ± 1.0	4.0 ± 1.2	< 0.001
Additional indicators
PMHS-C	3.5 ± 0.5	2.8 ± 0.6	< 0.001
Social support score	8.0 ± 1.5	6.5 ± 1.8	< 0.001
Community participation score	7.5 ± 1.2	5.8 ± 1.5	< 0.001
Psychological resilience score	8.2 ± 1.3	6.8 ± 1.6	< 0.001

SDSS: Social Disability Screening Schedule; PMHS-C: Positive Mental Health score.

Table 5 Treatment adherence and self-management, mean ± SD

Indicator	Intervention group (n = 60)	Control group (n = 60)	P value
Mean MMAS-8 score at baseline	5.8 ± 1.4	5.7 ± 1.3	0.74
Mean MMAS-8 score at 12 months	7.4 ± 0.8	6.1 ± 1.1	< 0.001
Increase in MMAS-8 score	1.6 ± 1.0	0.4 ± 0.8	< 0.001
Percentage of patients with high adherence (MMAS-8 ≥ 6)	85%	60%	< 0.001
Self-management of medications (%)	90	70	< 0.001
Adherence to follow-up appointments (%)	95	80	< 0.001
Implementation of lifestyle changes (%)	80	55	< 0.001
Correct implementation of skin care protocols (%)	85	60	< 0.001
Knowledge of disease management (%)	88	65	< 0.001
Adherence to dietary recommendations (%)	82	58	< 0.001
Engagement in regular physical activity (%)	75	50	< 0.001

MMAS-8: 8-item Morisky Medication Adherence Scale.

Table 6 Sleep quality and stress levels, mean ± SD

Indicator	Intervention group (n = 60)	Control group (n = 60)	P value
Mean PSQI score at baseline	10.2 ± 2.9	10.1 ± 2.8	0.82
Mean PSQI score at 12 months	4.8 ± 1.6	7.3 ± 2.1	< 0.001
Reduction in PSQI score	5.4 ± 2.3	2.8 ± 2.0	< 0.001
Mean PSS-10 score at baseline	25.4 ± 5.2	25.2 ± 5.1	0.85
Mean PSS-10 score at 12 months	12.6 ± 3.8	18.4 ± 4.5	< 0.001
Reduction in PSS-10 score	12.8 ± 4.1	6.8 ± 3.9	< 0.001
Percentage of patients with good sleep quality (PSQI ≤ 5)	70%	40%	< 0.001
Percentage of patients with low stress levels (PSS-10 ≤ 10)	65%	35%	< 0.001
Sleep latency (minutes)	20 ± 10	35 ± 15	< 0.001
Sleep duration (hours)	7.5 ± 0.8	6.2 ± 1.0	< 0.001

PSQI: Pittsburgh sleep quality index; PSS-10: Perceived stress scale.