34% of eczema self-management apps contain information inconsistent with international guidelines

Thirty-four per cent of eczema smartphone applications (apps) contain information which is inconsistent with international guidelines, particularly regarding treatments and the progression of the condition, according to a new study of 98 apps, published in the British Journal of Dermatology.

Eczema is one of the most common skin conditions in the world, and although it can occur at any age it is most common in childhood, affecting around 20 per cent of children in the UK at some point. Eczema cannot be cured, but it can be managed, usually with moisturisers (known as emollients).

This study reviewed English, Chinese, and Spanish eczema self-management smartphone apps aimed at patients and carers. Of the apps 67 were in English, 22 were in Chinese, nine were in Spanish. The researchers evaluated these apps using international eczema guidelines, including NICE guidelines from the UK, to assess eczema educational information, eczema specific tracking functions, and compliance with health information best practice principles.

Of the apps assessed, 84 per cent provided educational information, 39 per cent tracking functions, and 13 per cent both. Among 38 apps with a tracking function, 82 per cent measured specific symptoms, disease severity or current skin condition and 89 per cent helped users to record medication usage including application of topical (applied to the skin) treatments. 34 per cent recorded environmental or dietary allergens.

In addition to the 34 per cent of apps providing information which is inconsistent with international guidelines, only 15 per cent provided information supported by international guidelines on pharmacological therapies and 16 percent on non-pharmacological therapies. None of the included apps complied with all criteria for educational information, tracking functions or health information principles. Eleven per cent of the apps failed to mention mainstay therapies such as the use of emollients and moisturisers.

Associate Professor Josip Car of Nanyang Technological University, senior author, said: “The assessed eczema self-management apps had shortcomings, however certain apps did provide appropriate functions with accurate information and comprehensive tracking of eczema-related factors. Our research shows that there is a large variance in the quality of eczema apps. Perhaps the most useful way to address this issue would be to publish a list of recommended apps to aid clinicians in suggesting the appropriate options for eczema patients and caregivers.

“With room for further development of quality, the field of mobile health has great potential to better patient care and self-management of eczema and address major unmet needs, provided that appropriate measures are taken to improve the quality standards.”

Matthew Gass of the British Association of Dermatologists, said:“It is important that researchers continue to test the accuracy and safety of health apps. There has been an enormous boom in the number of dermatology apps available to the public, and with this comes the risk that some will be inaccurate, and even unsafe. Similar concerns have been raised in the past regarding skin cancer apps.

“App developers should clearly label the sources of their information and should make use of existing resources such as published NICE guidelines. There is no doubt that apps will play a big role in the self-management of skin conditions, but we should have high standards for any health apps.”

At the British Association of Dermatologists’ Annual Meeting in 2018 concerns were raised that a lack of thorough testing of skin cancer apps is a risk to public safety.