Overall, the ECO programme was a success, and we delivered a large programme of work ahead of schedule and to budget. Early work suggested that a feasibility trial was not necessary, and we commenced with an internal pilot. This contributed to completing ahead of time, allowing for the intervention to be redeveloped using commercial software within the life of the programme, such that it is already being rolled out and widely used.
We maintained good working links between the research teams in Nottingham, Southampton and our other partner institutions and strengthened links and collaborations with our host Solent NHS Trust and charity partners NES and EOS. Many of the research team are now working on related programme grants Rapid Eczema Trials and Acne Care Online and all continue to work in research.
Throughout the programme we used rigorous methodology and multidisciplinary subgroups, including PPI, to ensure high-quality research. We have produced 23 papers throughout the programme, including publishing our main trial paper in the BMJ with an accompanying BMJ opinion piece about ECO implementation. All our publications have been published on our programme website (www.nottingham.ac.uk/ECO) and Twitter (Twitter, Inc., San Francisco, CA, USA) (@ECO_eczema) with accompanying plain English summaries and/or a blog. Seven videos have also been disseminated and are available on our programme website.
Our clinical trial (workstream 4) started at the end of 2019 and when the COVID-19 pandemic started we had to adapt quickly to amend some trial processes and adjust to remote working. Online trials worked well, particularly in the COVID-19 era, but also for reducing the carbon footprint of research. We worked with a commercial provider to create www.eczemacareonline.org.uk in both English and Welsh to enable dissemination throughout the UK. There are ongoing challenges to keeping ECO freely available in the future.