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Campus
  1. Tool
  2. Source: Campus Sanofi
  3. 23 Oct 2023
5 min

Atopic Dermatitis Control Tool (ADCT)

Author: Sanofi

  
Doctor explained something

DUPIXENT(dupilumab) Prescribing Information GB

DUPIXENT (dupilumab) Prescribing Information NI/ROI

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-assessed 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:

*Please note: this link is for HCP reference only to aid understanding of the tool. Please use the following link when sharing it with your patients: Change AD UK: Atopic Dermatitis Patient Support

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.

ADCT is recommended by HOME3 

ADCT has been recommended by the Harmonising Outcome Measures for Eczema (HOME) initiative as one of the core instruments for assessing long-term control in atopic dermatitis.3

HOME is a global initiative of healthcare professionals, patients, carers, regulatory bodies, journal editors and the pharmaceutical industry to develop a consensus-based core outcome set for clinical trials. The core outcome set of parameters that are recommended by HOME to be measured in all clinical trials comprises:

  1. Clinician-reported signs of atopic dermatitis
    Recommended tool: Eczema Area and Severity Index (EASI)
  2. Patient-reported symptoms
    Recommended tools: Patient-Oriented Eczema Measure (POEM) and Numerical Rating Scale (NRS) 11 (for peak itch over past 24h)
  3. Quality of Life
    Recommended tools: Dermatology Life Quality Index (DLQI), Children Dermatology Life Quality Index (CDLQI), Infant Dermatology Life Quality Index (IDQoL)
  4. Long-term control of atopic dermatitis
    Recommended tools: Recap of atopic eczema (RECAP) and Atopic Dermatitis Control Tool (ADCT)

ADCT Scoring Instructions

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

 0 points1 point2 points3 points4 points

1. Over the last week, how would you rate your eczema-related symptoms?

NoneMildModerateSevereVery Severe

2. Over the last week, how many days did you have intense episodes of itching because of your eczema?

Not at all1-2 days3-4 days5-6 daysEveryday

3. Over the last week, how bothered have you been by your eczema?

Not at allA littleModeratelyVeryExtremely

4. Over the last week, how many nights did you have trouble falling or staying asleep because of your eczema?

No nights1-2 nights3-4 nights5-6 nightsEvery night

5. Over the last week, how much did your eczema affect your daily activities?

Not at allA littleModeratelyA lotExtremely

6. Over the last week, how much did your eczema affect your mood or emotions?

Not at allA littleModeratelyA lotExtremely

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

Interpreting the ADCT 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 7 points

Changes in control status over time

A change of 5 points in 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.

*Please note: this link is for HCP reference only to aid understanding of the tool. Please use the following link when sharing it with your patients: Change AD UK: Atopic Dermatitis Patient Support

Development of ADCT involved literature review as well as interviews with patients and physicians, and was funded by Sanofi and Regeneron.

References
  1. David M Pariser et al., 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
  2. Eric Simpson et al.,. 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
  3. http://www.homeforeczema.org/research/long-term-control.aspx. Accessed November 2023
Photo of the paper ADCT test

Atopic Dermatitis Control Test (ADCT)

Atopic dermatitis, a type of eczema, may be affecting your patient’s life in more ways than you know.

The ADCT gives a measure of how controlled your patient’s eczema is. Use these 6 concise questions to evaluate all dimensions of atopic dermatitis control.

Try the ADCT

MAT-XU-2304412 (v1.0) Date of Preparation October 2023