Emollient satisfaction questionnaire:validation study in children with eczema

BACKGROUND: Emollients are used as maintenance therapy for all severities of eczema but there is a lack of head‐to‐head comparisons of effectiveness and acceptability. AIM: To determine the validity of a self‐report questionnaire designed to assess user satisfaction with a given emollient and to report the findings. METHODS: Data were analysed from the Choice of Moisturiser for Eczema Treatment trial, which compared four emollient types (Aveeno(®) lotion, Diprobase(®) cream, Doublebase(®) gel and Hydromol(®) ointment) in children aged < 5 years with clinically diagnosed eczema. An emollient satisfaction questionnaire was completed after 12 weeks. Responses for individual items were scored from 0 to 4. Total scores ranged from 0 to 28 (low to high satisfaction). Completion rates and distributions of responses for individual items and total scores, categorized by emollient type, were assessed, and two hypotheses were tested to determine the questionnaire's construct validity. RESULTS: Data from 77.2% (152 of 197) of participants were analysed. One item was rejected because of a high rate (44.7%) of ‘don't know’ responses, leaving seven items with high completion rates (98.7%) and weak evidence of floor or ceiling effects. A positive association was observed between total score and overall emollient satisfaction (Spearman correlation 0.78; P < 0.001). Total scores were highest (mean ± SD 23.5 ± 3.9) in the lotion group and lowest (18.4 ± 4.6) in the ointment group. CONCLUSION: The emollient satisfaction questionnaire appears to have good validity. Further work is required to validate the questionnaire in other settings and to assess its reliability

Emollient prescribing formularies and guidelines in England, 2021:a cross-sectional study.

BACKGROUND: Emollients are a mainstay of treatment for dry skin conditions. In the UK, prescribers are usually expected to follow local National Health Service (NHS) formularies. A previous study in 2018 showed that the recommended emollients across England and Wales varied widely. Evidence has since emerged that bath additives provide no additional clinical benefit in eczema. AIM: To compare emollient formularies and guidelines in England. METHODS: Clinical Commissioning Group (CCG) formularies and guidelines were identified in April–May 2021, compiled and then analysed descriptively. RESULTS: In total, 105 CCGs, 72 emollient formularies and 47 emollient prescribing guidelines were identified. There were internal inconsistencies between formularies and their accompanying guidelines in 19% of cases. The majority (68%) of formularies/guidelines were organized using a ranking system. In total, 126 different leave‐on emollients were named. Creams and ointments were universally available and were the most recommended first‐line types. Cost was more likely than patient choice to be recommended as a criterion for selecting which emollient to prescribe. Aqueous cream was the leave‐on emollient most commonly not recommended. Nearly three‐quarters (74%) of formularies stated that bath additives should not be prescribed. CONCLUSION: All CCGs in England have an emollient formulary/guideline, but there is still great variability between them in their recommendations. Although the number of formularies/guidelines has reduced since 2017, there has been an increase in the total number of unique recommended leave‐on emollients. Most CCGs are no longer recommending bath emollients for eczema