Tips for Providing Better Atopic Dermatitis Care
Next Steps in Derm and the Journal of Drugs in Dermatology, in partnership with the Dermatology Education Foundation (DEF) and Physicians Resources, interviewed Dr.
Adam Friedman, professor and chair of dermatology at GW School of Medicine and Health Sciences. With the growing list of therapeutic options, Dr. Friedman encourages clinicians to go back to the basics and address one of the greatest challenges — treatment adherence. Watch as he addresses why educating patients is vital in this day and age, and why documentation is central not only for insurance coverage but also for patient buy-in.
Dr. Adam Friedman lectured on this and other topics at the recent DERM2022 NP/PA CME conference held July 28-31, 2022.
Further Reading
If you want to read more about atopic dermatitis, check out the following articles published in the Journal of Drugs in Dermatology:
ABSTRACT
Background: Recent data on unmet needs in the treatment of moderate to severe atopic dermatitis (AD) in the US are not available.
Objective: To describe disease control, quality of life (QoL), and treatment satisfaction in a United States population with moderate-to-severe AD.
Methods: Cross-sectional 2021 survey conducted among US patients recruited to an online survey from Kantar e-profiles, their panel partners, and Global Perspectives. Adults with self-reported, physician-diagnosed AD completed the primary survey. Of those reporting moderate to severe AD, a subset, including patients who “strongly disagreed,” “somewhat disagreed,” or were “neutral” on the statement “my eczema is adequately controlled” (“inadequately controlled”) with varying experience with approved biologic treatment (dupilumab), completed a second, enriched survey. Outcome measures evaluated included self-reported disease control and severity and validated measures including Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD), Dermatology Life Quality Index (DLQI), Recap of Atopic Eczema (RECAP), and Treatment Satisfaction Questionnaire for Medication (TSQM-9).
Results: Of 3,285 patients who participated in the primary survey, 1,935 self-reported moderate-to-severe AD, 979 (51%) of whom reported inadequate control. A total of 371 completed the enriched survey, leading to an analytic sample with 87 controlled patients and 284 inadequately controlled patients (178/284 inadequately controlled patients never received dupilumab, 23 previously received it, and 83 were currently receiving it). Mean RECAP, PO-SCORAD, and DLQI scores were significantly worse (P<0.01) for inadequately controlled vs controlled patients: 7.26 vs 13.9; 38.3 vs 26.9; and 9.9 vs 7.0, respectively. Mean TSQM-9 scores for inadequately controlled vs controlled patients were significantly worse across all domains—effectiveness, convenience, and global satisfaction (P<0.01): 45.5 vs 69.5, 62.3 vs 72.5, 48.3 vs 69.3, respectively.
Conclusions and Relevance: This study found about half of the patients had inadequate control of their disease. This may partially be due to underuse of systemic biologics in eligible patients. There remains an unmet need for additional education on current and new systemic biologics that could allow patients to achieve better AD control, improved QoL, and greater overall treatment satisfaction.
Measuring and Improving Adherence to Crisaborole 2% Ointment in Patients With Atopic Dermatitis
ABSTRACT
Background: Atopic dermatitis (AD) is an inflammatory skin condition with dry, scaly, and intensely itchy skin. Treatment failure is the result of poor adherence.
Objective: In this study, we assessed the impact of an internet-based survey on adherence to topical crisaborole 2% ointment in patients with mild AD.
Methods: Participants were randomized to the intervention or control group. The intervention group received weekly email surveys regarding adherence for 6 weeks, then monthly for 12 months. All participants came in for 5 visits over the year.
Results: Twenty-eight subjects were recruited for the study (n=19 adults, n=9 pediatrics). Adherence for adults that remained in study (n=6) was 60%. Adherence of the adult control and intervention groups were 49% and 45%, respectively (P>0.05). Adherence for pediatric participants that remained in study (n=2) was 6%. The adherence of the pediatric control and intervention groups were 27% and 29%, respectively (P>0.05).
Discussion: Medication adherence was low. The survey intervention did not improve adherence. However, more participants in the intervention group completed the study than in the control group of adults. Regular communication from the provider may help patients feel supported and continue treatment.
