New Initiative Establishes Good Care Practices for Atopic Dermatitis

Through the Atopic Dermatitis Quality of Care (ADQoC) Initiative, investigators primarily from the US identified several common challenges and established 10 good care practices for atopic dermatitis care.

The investigators, led by Emma Guttman, MD, PhD, believed that establishing said practices provided benefits for patients, healthcare providers, and the healthcare system.

The study was born out of what they considered “unrelenting” pruritus and recurrent eczematous lesions causes by atopic dermatitis, which has affected up to 15% of children and adolescents and up to 5% of adults.

The Initiative was launched on https://atopicdermatitiscare.kpmg.co.uk/ to provide an easy- to-use educational platform.

Prior to the launching of the website, Guttman and colleagues first established the challenges that impeded the management of atopic dermatitis.

The Study

Guttman and colleagues used literature and real-world experiences to determine good care practices and common challenges in the management of atopic dermatitis, resulting in a comprehensive literature review that established a baseline of challenges.

Literature from PubMed was collected from 2010 to present regarding AD care, treatment paradigms, and patient and healthcare provider behaviors. Primary research, reviews, and guidelines were also collected and reviewed.

Additionally, the team identified 32 expert centers in the care of AD worldwide.

The centers were surveyed and given interview questions that were targeted to identify challenges in care and how interventions are used to overcome this including: awareness of condition, screening, diagnosis, referral pathway from primary care to specialists, medical and non-medical management, access to multidisciplinary care, clinical management, follow-up care, and training of medical staff.

Each site was visited during a 2-day survey period, and open field commentary and discussion with participants had occurred.

The Findings

Overall, 4 common challenges to care were identified: misconceptions about atopic dermatitis, delayed referral and access to atopic dermatitis specialists, poor patient access to atopic dermatitis treatments and poor adherence and managing the complexity of atopic dermatitis and its comorbidities.

Common issues within the 4 established challenges revolved around a lack of knowledge on atopic dermatitis, whether by patients or medical professionals, as well as a lack of resources and availability of treatment methods.

Despite this, Guttman and colleagues identified good practice implementations, such as clinical assessment and diagnosis, coordinated and structured multidisciplinary care teams, monitoring and evaluating care quality, patient education and communication, and collaboration and exchange with patient groups.

The team considered collaboration and exchange with patient groups to be “considerably beneficial”, as it provided patients with greater access to resources, support, and information not typically provided by centers.

Additionally, healthcare providers could benefit from collaborating with patient groups, as it offers effective outsourcing and support of patients that the providers and centers may not have the time or expertise to provide.

Overall, the investigators were confident in their findings, and believed the good care practices they established within the study could be implemented in any practice and were integral in maintaining and improving good patient care.

“Clear benefits of these good practices can obviously benefit patients, ultimately improving their quality of life; and additionally, benefit patient advocacy groups, individual healthcare providers, and healthcare systems,” the team said.

The study, “Pioneering Global Best Practices in Atopic Dermatitis: Results from the Atopic Dermatitis Quality of Care Initiative,” was published online in Clinical and Experimental Rheumatology.