Risks for comorbidity in children with atopic disorders: an observational study in Dutch general practices

Pols, David H. J.; Bohnen, Arthur M.; Nielen, M.; Korevaar, Joke C.; Bindels, Patrick J E

doi:10.1136/bmjopen-2017-018091

Cited by 23 publications

(29 citation statements)

References 39 publications

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“…Alopecia areata frequently shows the strongest association [46,47], which would be consistent with the higher prevalence of hair and hair follicles diseases found in our sample. Psoriasis was also more prevalent in our population with AD, as previously described by Pols et al [40]. The association of central obesity with AD was already reported, especially in women [16].…”

Section: Discussionsupporting

confidence: 90%

“…Regarding visual impairment, the third most frequent comorbidity in our study (7.8%), Pols et al [40] found an association between AD (OR (95% CI)) and blepharitis/styes/chalazion (1.53 (1.29-1.81)), infectious conjunctivitis (1.53 (1.20-1.81)), and allergic conjunctivitis (1.99 (1.59-2.49)) after analyzing a nationwide primary care database of children in the Netherlands. However, since the exact prevalence of each of the diagnoses included in the visual impairment EDC was unavailable, we were unable to contrast their results with our own.…”

Section: Discussionsupporting

confidence: 54%

“…Additionally, low vitamin D blood levels in AD patients might also contribute to the skeletal burden [44]. Pols et al found a higher prevalence of foot/toe-related symptoms (1.39 (1.20-1.60)) and acquired deformities of the limbs (1.39 (1.20-1.60)) in their study [40]; however, the association between AD and congenital limb anomalies or kyphoscoliosis was not established.…”

Section: Discussionmentioning

confidence: 73%

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Prevalence and Comorbidity of Atopic Dermatitis in Children: A Large-Scale Population Study Based on Real-World Data

Gilaberte

Pérez-Gilaberte

Poblador‐Plou

et al. 2020

JCM

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This study aimed at exploring atopic dermatitis (AD) prevalence in children and exhaustively analyzing their comorbidity. We conducted a descriptive analysis of their socio-demographic and comorbidity characteristics in the EpiChron Cohort (Aragón, Spain). Adjusted odds ratios (OR) were calculated for each comorbidity using logistic regression models. In total, 33,591 children had a diagnosis of AD, resulting in an overall prevalence of 15.5%. AD prevalence was higher in girls compared to boys, in 3–9-year-olds compared to children of other ages, and in Spanish children compared to those of other nationalities. Multimorbidity was present in 43% of children, with the most frequent chronic comorbidities being asthma (13.1%), psychosocial disorders (7.9%), and visual impairment (7.8%). Many diseases were, regardless of their prevalence, statistically associated with AD. The strongest associations (odds ratio (OR) (95% confidence interval (CI))) were found in asthma (2.10 (2.02–2.17)), allergic rhinitis (2.00 (1.91–2.10)), and irritable bowel syndrome (1.90 (1.56–2.31)). A better understanding of the array of comorbidities associated with AD in children might help improve their clinical management. Future longitudinal studies are encouraged to shed light on the potential underlying pathophysiological mechanisms involved in the identified associations.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 73%

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Prevalence and Comorbidity of Atopic Dermatitis in Children: A Large-Scale Population Study Based on Real-World Data

Gilaberte

Pérez-Gilaberte

Poblador‐Plou

et al. 2020

JCM

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“…Children who have one atopic disorder are at risk of developing other atopic disease(s). 32 Subsequently, more intense physical symptoms in comorbidity are likely to influence parental distress and poorer family functioning. In addition, it seems that parental functioning and wellbeing in our study were impaired to a lesser extent if the child affected with AD was older.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with improvement of quality of life among parents of children with atopic dermatitis: 1‐year prospective cohort study

Maksimović

Zaric²,

Reljić

et al. 2019

Acad Dermatol Venereol

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Background Previous studies exploring the impact of atopic dermatitis (AD) in children focused on factors associated with parental quality of life at one point in time. Objective To examine factors associated with change of quality of life among parents of children affected with AD. Methods The study cohort comprised 98 parent–children pairs treated for AD at the Clinic of Dermatovenereology; however, 18 parents (18.4%) were lost to follow‐up after 1 year. Children were assessed with SCORing Atopic Dermatitis Index (SCORAD) and Children Dermatology Life Quality Index (CDLQI) or the Infants’ Dermatitis Quality of Life Index (IDQOL), depending on their age. Parents filled in socio‐demographic questionnaire and Dermatitis Family Impact Questionnaire (DFI). After 1 year, both children and parents were reassessed using the same AD‐related battery of questionnaires. Results After follow‐up, a significant improvement in the average total DFI score was observed, especially for domains of fatigue/exhaustion, emotional distress and impact of helping in child treatment. Lower baseline SCORAD, greater improvement of SCORAD over follow‐up, better CDLQI/IDQOL at baseline, greater improvement in CDLQI/IDQOL over follow‐up, not having asthma and having older child with AD were associated with better parental quality of life after 1 year of follow‐up. Parental higher education level, shorter AD duration, better baseline SCORAD and greater improvement in CDLQI/IDQOL over follow‐up were associated with greater improvement in parental life quality over 1 year of follow‐up. Conclusion Contributors to parental quality of life after 1 year included clinical features of AD and child's comorbidity (asthma), but also the perception of child's quality of life and its improvement.

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“…The symptoms include recurrent episodes of wheeze, cough and breathlessness 3. Asthma in children is associated with significant comorbidity, for example, other airway symptoms and/or (infectious) diseases 4. Moreover, the symptoms may have a considerable impact on the quality of life of children with asthma and their parents, as well as on healthcare costs.…”

Section: Introductionmentioning

confidence: 99%

Protocolled practice nurse-led care for children with asthma in primary care: protocol for a cluster randomised trial

et al. 2019

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IntroductionIn children with asthma, daily symptoms and exacerbations have a significant impact on the quality of life of both children and parents. More effective use of asthma medication and, consequently, better asthma control is advocated, since both overtreatment and undertreatment are reported in primary care. Trials in adults suggest that asthma control is better when patients receive a regular medical review. Therefore, protocolled care by the general practitioner may also lead to better asthma control in children. However, such protocolled care by the general practitioner may be time consuming and less feasible. Therefore, this study aims to determine whether protocolled practice nurse-led asthma care for children in primary care provides more effective asthma control than usual care.Methods and analysisThe study will be a cluster-randomised open-label trial with an 18-month follow-up. Practice nurses will be the units of randomisation and children with asthma the units of analysis. It is planned to include 180 children aged 6–12 years. Primary outcome will be average asthma control during the 18-month follow-up measured by the Childhood Asthma Control Test (C-ACT). Secondary outcomes include C-ACT scores at t=3, t=6, t=12 and t=18 months; the frequency and severity of exacerbations; cost-effectiveness; quality of life; satisfaction with delivered care; forced expiratory volume in 1 s and forced expiratory flow at 75% and the association of high symptoms scores at baseline and baseline characteristics. Besides, we will conduct identical measurements in a non-randomised sample of children.Ethics and disseminationThis will be the first trial to evaluate the effectiveness of protocolled practice nurse-led care for children with asthma in primary care. The results may lead to improvements in asthma care for children and can be directly implemented in revisions of asthma guidelines.The study protocol was approved by the Medical Research Ethics Committee of the Erasmus Medical Centre in Rotterdam.Trial registrationNTR6847.

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Risks for comorbidity in children with atopic disorders: an observational study in Dutch general practices

Cited by 23 publications

References 39 publications

Prevalence and Comorbidity of Atopic Dermatitis in Children: A Large-Scale Population Study Based on Real-World Data

Prevalence and Comorbidity of Atopic Dermatitis in Children: A Large-Scale Population Study Based on Real-World Data

Factors associated with improvement of quality of life among parents of children with atopic dermatitis: 1‐year prospective cohort study

Protocolled practice nurse-led care for children with asthma in primary care: protocol for a cluster randomised trial

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