Atopic Dermatitis Study Characterizes Therapeutic Patient Education Attendance

Sébastien Barbarot, MD, PhD

A study from France characterized patients with atopic dermatitis who attended therapeutic patient education programs, noting that moderate-to-severe disease was common among attending patients.

However, overall attendance was low despite the expansion of such programs across the country.

The observational, cross-sectional study was conducted by Sébastien Barbarot, MD, PhD, of Nantes University Hospital, and colleagues, where they circulated a survey to parents of children (6 – 17 years) and adults 18 and older.

The aim of the study was to elucidate the type of patients and parents who attended therapeutic education sessions by describing sociodemographic and clinical characteristics.

“A better understanding of such characteristics may help to reach categories of patients who do not usually make use of them,” Barbarot and colleagues wrote.

The Study

The team collected data from 1063 children and parents. Relevant data included program attendance, sex, age, and area of origin. For either or both parents, the investigators inquired about presence of atopic dermatitis, professional level, and feelings of guilt or of neglecting siblings.

Clinical severity of children was assessed by parents using a proxy version of the Patient-Oriented Eczema Measure (POEM), which asked about frequency of itch, sleep, bleeding, weeping, cracking, flaking off, and dryness during the previous week.

Total scores for each category were added together and severity was ascertained from the overall combined score. Furthermore, parents were explicitly asked to evaluate their child’s disease severity as mild, moderate, or severe.

The Results

The overall attendance rate among the entire population was 12.3% (n = 131), and the majority of attendees went for 2-5 sessions.

“In the group attending therapeutic patient education, there were 85 boys (64.9%), and severity evaluated by POEM was mild in 29.8%, moderate in 52.7% and severe in 17.6% of patients,” the investigators reported.

While there were no associations between distance to program centers and attendance, the team observed that urban regions with high numbers of inhabitants like Paris and Normandy had high rates of attendance.

Furthermore, therapeutic patient education sessions had higher rates of attendance among parents who were young, employed, had atopic dermatitis or a history of atopic dermatitis, and had feelings of guilt or of neglecting their other children.

“Concerning clinical characteristics of atopic dermatitis,” the investigators wrote, “the prevalence of parents/children attending therapeutic patient education sessions was higher when the disease was more severe, and when children had a consultation with a dermatologist or a pediatrician.”

A logistic regression model supported strong associations between attendance and the sex of the child as well as the aforementioned clinical characteristics.

Conclusion

Several limitations acknowledged by Barbarot and his team were lack of details on sessions as well as barriers to attendance. They noted that it is possible that some patients/parents may never have been offered the option among those who never attended a therapeutic patient education session.

“Further research should focus on determinants and barriers of therapeutic patient education programs access in patients with AD in order to improve attendance,’ they opined. “In particular, therapeutic patient education should be more integrated in primary care system in France instead of being restricted to tertiary hospitals.”

The study, “Characteristics of children and adolescents with atopic dermatitis who attended therapeutic patient education,” was published online in the The Journal of The European Academy of Dermatology and Venereology.