BUENOS AIRES (Reuters Health) - A clinic led by nurses appears to be more effective in reducing the severity of dry skin rashes or "atopic eczema" in infants, children and adolescents than a clinic led by a dermatologist, the results of an Australian study suggests.
"It doesn't mean that dermatologists are not well trained, but that they don't have enough time," said led author Elizabeth Moore, dermatology nurse consultant at the Royal Children's Hospital, in Melbourne.
In the study, 49 children newly referred to the hospital for the management of atopic eczema were attended by nurses, while another 50 children were treated by dermatologists and pediatricians. Disease severity was graded according to a standard scoring system.
Moore and her colleagues found that patients in the nurse's group had a "significantly greater improvement in severity of eczema." According to Moore, more patients in the nurse-led clinic improved from moderate to mild disease. They bathed and applied emollients more often, and they managed their wet dressings consistently better as well: 76 percent of the time compared with only 12 percent of the patients in the dermatologist-led clinic.
A key factor appears to be consultation time. On average, children in the nurse-led clinic spent 90 minutes in individual and group sessions, including education about eczema and prescription of a management plan for each patient. By contrast, dermatologists and pediatricians spent only 40 minutes with their patients.
"Increased time spent with patients, allowed for more education and demonstration of treatments, which resulted in greater patient adherence to management and in turn a greater reduction in severity of atopic eczema," researchers said here this week at the 12th World Congress of Dermatology.
Moore considers that because of increasing time constraints for doctors, the role of nurses as educators within nurse-led clinics might play a central roll in the management of many other diseases as well.
"In fact, I think that most chronic diseases could be treated this way," she told Reuters Health.
