The following is a summary of the “Patients’ and Caregivers’ Experiences With Atopic Dermatitis–Related Burden, Medical Care, and Treatments in 8 Countries,” published in the January 2023 issue of Allergy and Clinical Immunology by Capozza, et al.
The major objective of this study was to characterize and evaluate health-related quality of life, symptom control over the long term, satisfaction with treatments, financial burden, and the prevalence of patient-centered care among adult and pediatric patients with atopic dermatitis (AD) in 8 developed nations. They created a 53-item, anonymous online survey for AD patients and their carers (N = 3171; self-reported disease severity: 8.2% clear, 33.2% mild, 41.1% moderate, 17.6% severe). A steering committee of 11 patient advocacy organizations for people with AD in the 8 nations chose the survey questions from among 7 different categories. They employed standardized tests, such as the 5-point EuroQol 5-dimensional questionnaire and the Atopic Dermatitis Control Tool, when possible. The survey was made available in 5 different languages and marketed through the patient advocacy groups’ social media and other lines of communication.
Health-related quality-of-life scores for adult patients with AD (0.72; 95% CI, 0.65-0.78) were worse than those reported for asthma and type 2 diabetes in earlier research (both of which were driven by the areas of pain/discomfort and anxiety/depression). Even in countries with publicly supported healthcare systems, patients and carers nevertheless reported significant financial implications, with the United States seeing the highest of these. Adults reported greater symptom management than children across the board, but no one in any country felt they had it under control (rescaled mean, 57.5; 95% CI, 56.1-58.9), reflected in a negative correlation between control and illness severity. Similarly, patients reporting more severe disease symptoms were significantly less satisfied with treatments (F(3,3165) = 5.5; P< .001). Long-term symptom control was better in AD patients who attended a specialist (a dermatologist or allergist) as opposed to a primary care physician (95% CI, 2.6-5.4; P< .001).
Finally, patients rarely reported receiving self-management training and shared decision-making everywhere except the United States, despite both being linked to better long-term control of symptoms and higher satisfaction. Patients with more severe atopic dermatitis report more difficulty achieving symptom resolution with current treatments and approaches to care. As a result, bear a disproportionate share of the burden of AD, measured as health-related quality-of-life losses, financial impacts, and uncontrolled symptoms. Patients, especially those with more severe forms of AD, may benefit from medical care guided by doctors with more in-depth knowledge of this complicated disorder, as suggested by the higher outcomes associated with respondents who consulted specialists.
Last but not least, expanding the use of patient-centered care approaches (such as self-management training and shared decision-making) may help improve treatment results and patient satisfaction for AD, however, additional study is needed.
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