Eczema website delivers for patients and the NHS

A website that helps people with eczema to manage their symptoms could be saving the NHS hundreds of thousands of pounds, according to new research by the University of Southampton.

The website, EczemaCareOnline.org.uk, or ECO for short, was developed by researchers at the University of Southampton. A new study published in The European Journal of Health Economics found that those using the website had improved quality of life as well as lower hospital care and medication costs.

The findings suggest the website saves the NHS between £20.82 and £34.15 per patient with eczema (or parent of child with eczema) who visits. Given the website has now been visited by more than 35,000 people, the potential savings to the NHS to date could range from £700,000 to over £1 million.

Tracey Sach, Professor of Health Economics at the University of Southampton and lead for the economic component of the study said, "Our previous paper in the BMJ demonstrated that the ECO website helped improve symptoms and outcomes for children and young people with eczema. Now, this new work demonstrates that this free-at-point-of-use website is low-cost to run and cost-effective for the NHS."

Eczema is a skin condition characterized by inflammation and irritation of the skin, often presenting red, itchy and dry patches of skin. It can affect people of all ages but is most common in infants and children. The condition is very common and has considerable impacts on people's quality of life—as well as significant costs for the NHS.

Appropriate and consistent advice around treatments and management of the condition can make living with eczema easier for those who experience the condition and their caregivers. But health professionals often don't have enough time to go into detail about how to look after eczema and people with eczema and their families often report they have been given insufficient information about the condition and how to manage it.

EczemaCareOnline.org.uk incorporates evidenced-based resources that have been shown to improve symptoms and behavior change techniques to help patients self-manage their condition. It provides information on what eczema is, how to use eczema treatments, how to avoid potential trigger factors that might make eczema worse and support for living well with eczema through videos and written resources.

In the study, 650 participants were either given access to the website alongside usual care, or usual care alone from a clinician. The participants who accessed the website were shown to have improved quality of life and reduced NHS costs after twelve months, compared to those who received usual care alone. The new research paper comes after a paper in the BMJ in 2022 that found the website improved eczema symptoms in children and young people.

Researchers have made the online self-management website for eczema freely available at www.EczemaCareOnline.org.uk and it has been used by more than 35,000 people in its first year.

"Use of the website is a win-win," says Miriam Santer, Professor of Primary Care Research at the University of Southampton and co-author of the study. "Parents and young people are able to take control of their condition and the NHS can reduce costs and provide people with evidence-based information that could otherwise be missed within a short primary care appointment."

Kate's daughter Ellie (age 12), from the Portsmouth area, had severe and unresponsive eczema from when she was just 6 weeks old. "I had never dealt with this condition before, and I understood it to be a mild irritation that is quickly fixed by some moisturizer. The reality is far more complex. Life quickly became a whirlwind of flare-ups, infections, lotions, and potions. I spent lots of money on the latest 'miracle' products which sometimes made things even worse.

"Eczema Care Online really is a one-stop shop for everything you could ever need to know about understanding and managing eczema. It's reassuring to know that all of the information on there is thoroughly researched and up to date."

Researchers spoke to parents and young people who had used the website to understand what made it effective. They said the website helped them to better understand eczema, reassured them about the safety of treatments, and made them feel more confident in using treatments. They also said that reading about the experiences of others with eczema helped young people to feel 'normal' and less alone. One said, "ECO is great if I have a quick question about something. Before I would have harassed my mum to take me to the doctors, which is a pain if you just have a very basic question, but now I just have a look on ECO."

Professor Santer said, "The main change was greater confidence in managing eczema and understanding how treatments work, for example, the difference between regularly using moisturizers to prevent flare-ups and the prompt use of topical corticosteroids to manage flare-ups."