PA07 IMPEED study: preliminary results of the IMPact of Eczema on EDucational participation and achievement among children in Ireland
Authors: Cassidy Aoife , Browne Fiona , Hourihane Jonathan 
Published: June 2024

Abstract
The IMPEED study is a mixed-methods cohort study of the impact of eczema on educational achievement and participation among children. Eczema is one of the most common chronic conditions in childhood and affects up to 20% of children in Ireland. There is significant literature on the effects of chronic disease on learning and school engagement, but there are few studies that examine eczema as one of these diseases. Children aged 6–16 years with a diagnosis of eczema were recruited from paediatric dermatology clinics. Eczema Area and Severity Index (EASI), Children’s Dermatology Life Quality Index (CDLQI) and Patient-Oriented Eczema Measure (POEM) scores were recorded. The caregiver and child undertook a questionnaire documenting demographics, dermatological and medical history, learning needs, and information regarding the effect of eczema on school life, extracurricular activities and social life. To date, 78 patients have been recruited. Their mean age is 10 years, 46 are male (59%), and 14 patients (18%) are on systemic therapies for their eczema. Fifty-three children (68%) reported that eczema impacts their school day. Self-consciousness about skin appearance and scratching, distress due to itch, poor concentration and distraction, sore cracked hands affecting writing, and tiredness were the main reasons given. Fifty-four participants (69%) have missed school, primarily due to infective exacerbations, tiredness from sleep disruption, inability to wear uniforms or shoes due to pain, and medical appointments. Twenty-three patients (29%) have additional learning support in school, compared with &lt; 8.5% of the general population. Of the children in our cohort receiving additional support the average EASI is 11.2, compared with 10.9 in those without learning support (P = 0.8), while the respective average CDLQI scores were 10.8 vs. 8.4 (P = 0.08), and the average POEM 18.7 vs. 15.1 (P = 0.05). Fifty-three participants (68%) reported eczema affects their extracurricular activities. Self-consciousness about skin exposure, worsening itch when hot or sweaty, exacerbations with aeroallergen exposure, and uniforms or equipment causing pain or irritation – particularly with cracked hands or feet – are barriers to participating in sporting activities. Twenty participants (26%) stopped attending swimming because of their eczema, mostly due to infective exacerbations, stinging skin and its drying effects. Forty-two participants (54%) reported that eczema affects their social life. This is mostly due to anxiety about meeting new people, embarrassment and upset about questions and comments from others, avoiding activities they believe may exacerbate their eczema, and missing parties and sleepovers. The preliminary results of the IMPEED study emphasize the impact of eczema on children’s school engagement. Participants had higher rates of additional educational support than the general population, and those requiring additional learning support had higher eczema scores than those without. Objective academic measures are awaited.