SOURCE: Sauder MB, McEvoy A, Ramien ML. Prescribing success: Developing an integrated prescription and eczema action plan for atopic dermatitis. J Am Acad Dermatol 2016;75:1281-1283.
Many clinicians may be familiar with the concept of an action plan in reference to asthma management. National guidelines suggest that providing patients with a stratified plan to address intensification of their asthma treatment regimen based on symptoms and measurements of peak flow rates may enhance control.
Recently, similar advice has been offered — and supported by favorable outcomes from a randomized, controlled trial — for patients suffering from atopic dermatitis.
The proposed atopic dermatitis action plan features three ‘zones’ (green, yellow, and red), similar to asthma action plans. In the green zone, eczema is ‘under control,’ and patients should continue their daily moisturizer, possibly with use of their topical steroid and/or topical calcineurin inhibitor (e.g., tacrolimus, pimecrolimus). The yellow zone indicates worsening eczema, which calls for increased dosing of steroids or calcineurins. The red zone indicates uncontrolled eczema, which indicates that clinician contact is appropriate and a prescription for stronger corticosteroids is needed.
At this point, action plans for eczema are a fairly new concept. It is anticipated that such action plans will evolve as we learn more about their efficacy in enhancing patient self-care and timely consultations.