Effectiveness of a skin care program for the prevention of contact dermatitis in healthcare workers (the Healthy Hands Project): a single centre, cluster randomized controlled trial

Background

Healthcare workers (HCW) are at risk for developing hand dermatitis (HD). Guidelines recommend moisturizers to prevent HD, but in practice their effectiveness is poorly investigated.

Objectives

To assess whether an intervention aimed at improving skin care leads to reduction in HD severity.

Methods

In this 1‐year RCT, 9 wards (285 HCW) were allocated to an intervention group (IG) and 10 wards (216 HCW) to the control group (CG). The intervention included provision of cream dispensers with electronic monitoring of use, regularly communicated to the HCW. The primary and secondary outcomes were change from baseline in Hand Eczema Severity Index (∆HECSI) and Natural Moisturizing Factor (∆NMF) levels.

Results

At 12 months, lost‐to‐follow‐up was 41% and 39% in the IG and CG, respectively. The HECSI was reduced in the IG by ‐6.2 (95%CI ‐7.7,‐4.7) and in the CG by ‐4.2 points (95%CI ‐6.0,‐2.4). There was no difference in ∆HECSI or ∆NMF between groups. Relative improvement in HECSI was significantly higher in the IG than in CG (56% vs. 44%). In a subgroup of HCW with mild HD, IG showed larger HECSI decrease than CG (P<0.001)

Conclusion

Although there was no significant effect on the primary outcomes, the intervention showed overall positive effects on HECSI.

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