Report Details Racial/Ethnic Differences in Treatment Satisfaction, Provider Trust in Atopic Dermatitis

Candrice Heath, MD
Credit: Temple University

Results of a new study presented at paint a grim picture of the reality of life and management of atopic dermatitis for many in the US.

Data from the study, which were presented at the Revolutionizing Atopic Dermatitis (RAD) 2024 Annual Meeting, detail differences in perception of treatment and provider satisfaction across different racial and ethnic groups, with results indicating more than 1 in 3 Black patients reporting dissatisfaction with their current treatment regimen and 50% of Asian patients reporting low levels of trust in their healthcare provider (HCP) to effectively treat their atopic dermatitis.¹

“Nearly a quarter of patients living with [atopic dermatitis] reported not being able to access medicine or healthcare in the past year,” wrote investigators.¹ “Although there were differences in the percentages reported by race and ethnicity, some patients indicated there were gaps with regards to the patient-physician relationship around not feeling completely listened to, understood, or trusting HCPs treating [atopic dermatitis].”

Since the turn of the century, with the seeds sown even earlier, the dermatology community has made a concerted to effort to emphasize the importance of equitable healthcare for patients with dermatological conditions, including atopic dermatitis. A key example, the Skin of Color Society was founded in 2004 by a group of 15 dermatology professionals. Since founding, the organization has sought to contribute to equity within skin of color dermatology through research, education, mentorship, and advocacy.^2,3

In the current study, a team lead by Candrice R. Heath, MD, assistant professor of Dermatology at the Lewis Katz School of Medicine at Temple University, sought to illustrate racial and ethnic differences in treatment use, satisfaction, and perceptions of HCP interactions based on racial and ethnic differences among adult patients with atopic dermatitis. With this in mind, Heath and colleagues designed their study as an analysis of data recorded from a 1-time electronic survey completed by adults with self-reported atopic dermatitis recruited through the National Eczema Association and the AmeriSpeak panel.¹

The survey used in the study was described as an 80- to 110-item electronic survey with questions on overall atopic dermatitis severity over the last month, current atopic dermatitis treatment, current atopic dermatitis treatment satisfaction, atopic dermatitis provider type, and perceptions of their interactions with HCPs. In total, 260 patients completed the survey and were included in the analysis, including 18 from the National Eczema Association and 2423 from the AmeriSpeak panel.¹

The overall study cohort had a mean age of 40.6 years and 66.2% were female. In regard to race, 55.0% were White, 23.5% were Black/African American, 11.5% were Asian, 10.0% were American Indian/Alaskan Native, Native Hawaiian or Other Pacific Islander, or other/multiple races. Investigators pointed out 49.6% reported mild atopic dermatitis while 43.1% reported severity as mild and 7.3% reported having severe disease.¹

Upon analysis, investigators found 28.2% reported being dissatisfied or very dissatisfied with their current treatment regimen, with treatment dissatisfaction was greatest among Black/African American patients (36.2%). In the past year, 22.6% reported themselves or a household member had been unable to get medicine or healthcare, with this reported by 32.2% of Black/African American patients, 21.1% of White patients, 13.3% of Asian patients, and 20.0% of Hispanic/Latino patients.¹

Only 49.2% of patients who completed the survey indicated they saw a dermatologist for medications to treat their atopic dermatitis. Other common responses for care providers were primary care (33.1%), allergists (4.2%), and not seeing any provider (10.4%) for their atopic dermatitis.¹

Questions related to perception of satisfaction with their provider, 39.1% reported their HCP listened to their concerns related to “somewhat” or “a little bit” and 42.1% reported they “somewhat” or “a little bit” trust their HCP effectively treats their atopic dermatitis. Additionally, investigates found 3% of respondents did not trust their HCPL to effectively treat their atopic dermatitis “at all” and 1.3% reported their HCP did not understand their perspective “at all”.¹

“These findings may help inform clinical practice considerations in [atopic dermatitis],” investigators added.¹

References:

1. Heath CR, She VY, Begolka WS, et al. Patient opinions on healthcare provider interactions and current treatment satisfaction in adults with atopic dermatitis by race and ethnicity. Abstract presented at Revolutionizing Atopic Dermatitis 2024. Chicago, Il. June 08-10, 2024.
2. Desai SR, Khanna R, Glass D, et al. Embracing diversity in dermatology: Creation of a culture of equity and inclusion in dermatology. Int J Womens Dermatol. 2021;7(4):378-382. Published 2021 Aug 5. doi:10.1016/j.ijwd.2021.08.002
3. About SOCS - Skin of Color Society. Skin of Color Society. Accessed June 12, 2024. https://skinofcolorsociety.org/who-is-socs/about-socs.