Introducing ADCT

Atopic Dermatitis Control Tool (ADCT) – a validated, brief and easily scored tool
Six concise questions to evaluate all dimensions of atopic dermatitis (AD) control identified as relevant by patients and clinicians
ADCT can be self-administered by patients or used in routine consultations
ADCT is designed to help facilitate meaningful patient–physician discussion on control of AD in every day clinical practice, enabling improvements in disease monitoring

Development of ADCT involved interviews with patients as well as physicians. Six main areas were found critical in assessing the multi-dimensional aspects of disease control over the course of a week, and form the basis of ADCT:

ADCT validation

ADCT was rigorously tested with 270 US patients who were clinically diagnosed with AD by a healthcare professional, and were using a prescription treatment for AD within the past 6 months (not including oral antihistamines or oral antibiotics)1. Two studies confirmed that ADCT is a valid and reliable tool for assessing AD control and that it can be used to detect change of disease activity in a person over time^1,2.

Please see reverse side for ADCT scoring instructions

The Atopic Dermatitis Control Tool (ADCT) was developed to facilitate patient-physician discussion on control of atopic dermatitis.
The ADCT is not intended to replace the physician’s medical judgment in diagnosing and treating the patient.

ADCT – Atopic Dermatitis Control Tool

The Atopic Dermatitis Control Tool (ADCT) was developed to facilitate patient-physician discussion on control of atopic dermatitis. The ADCT is not intended to replace the physician’s medical judgment in diagnosing and treating the patient.

Using ADCT in clinical practice

To use ADCT correctly, your patient must answer all six ADCT questions by selecting the most appropriate answer.

		0 points	1 point	2 points	3 points	4 points
1.	Over the last week, how would you rate your eczema-related symptoms?	None	Mild	Moderate	Severe	Very Severe
2.	Over the last week, how many days did you have intense episodes of itching because of your eczema?	Not at all	1-2 days	3-4 days	5-6 days	Every day
3.	Over the last week, how bothered have you been by your eczema?	Not at all	A little	Moderately	Very	Extremely
4.	Over the last week, how many nights did you have trouble falling or staying asleep because of your eczema?	No nights	1-2 nights	3-4 nights	5-6 nights	Every night
5.	Over the last week, how much did your eczema affect your daily activities?	Not at all	A little	Moderately	A lot	Extremely
6.	Over the last week, how much did your eczema affect your mood or emotions?	Not at all	A little	Moderately	A lot	Extremely

Calculating the ADCT score

Step 1:	Each ADCT question is scored 0–4 points, as shown in the table above
Step 2:	The sum of the scores from all six ADCT questions forms the ADCT total score The minimum score is 0, the maximum score is 24

Patient’s ADCT total score:

Date recorded:

Interpreting the ADCT total score

Point in time control status

A higher score indicates lower AD control

A patient’s AD may not be well controlled if:

The ADCT total score is at least 7points

Changes in control status over time

A change of 5 points is the threshold for meaningful
within person change

Decrease of 5 points or more: indication of clinically relevant improvement of AD control
Increase of 5 points or more: indication of clinically relevant worsening of AD control

Recommendations for using ADCT in clinical practice

Your patient’s AD may not be well controlled if:

Their ADCT total score is at least 7 points

OR

Their ADCT total score has increased by 5 points or more since they last used ADCT

If you are concerned that your patient’s AD is not well controlled, you might want to initiate further conversations about optimal management of their AD.

References

David M Pariser, Eric L Simpson, Abhijit Gadkari, Thomas Bieber, David J Margolis, Michelle Brown, Lauren Nelson, Puneet Mahajan, Matthew Reaney, Isabelle Guillemin, Usha G Mallya, Laurent Eckert. Evaluating patient-perceived control of atopic dermatitis: design, validation, and scoring of the Atopic Dermatitis Control Tool (ADCT). Current Medical Research and Opinion 2019.
DOI: 10.1080/03007995.2019.1699516
Eric Simpson, Laurent Eckert, Abhijit Gadkari, Usha G Mallya, Min Yang, Lauren Nelson, Michelle Brown, Matt Reaney, Puneet Mahajan, Isabelle Guillemin, Mark Boguniewicz, David Pariser. Validation of the Atopic Dermatitis Control Tool (ADCT©) using a longitudinal survey of biologic-treated patients with atopic dermatitis. BMC Dermatology 2019;19:15. DOI: 10.1186/s12895-019-0095-3