ADCT – Atopic Dermatitis Control Tool
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 time1,2.
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.
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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