The Burden of Childhood Atopic Dermatitis in the Primary Care Setting: A Report from the Meta-LARC Consortium

Al-Naqeeb, Jinan; Danner, Sankirtana; Fagnan, Lyle J.; Ramsey, Katrina; Michaels, LeAnn; Mitchell, J R A; Branca, Kelsey; Morris, Cynthia D.; Nease, Donald E.; Zittleman, Linda; Levy, Barcey T.; Daly, Jeanette M.; Hahn, David L.; Dolor, Rowena J; Williams, Hywel C; Chalmers, Joanne R; Hanifin, Jon M.; Tofte, Susan J.; Zuckerman, Katharine E.; Hansis, K.; Gundersen, Mollie; Block, Julie; Karr, F.; Dunbrasky, S.; Siebe, Kathy; Dillon, Kristen; Cibotti, Ricardo; Lapidus, Jodi; Simpson, Eric L.

doi:10.3122/jabfm.2019.02.180225

Cited by 26 publications

(20 citation statements)

References 38 publications

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“…Atopic dermatitis (AD) is a chronic, relapsing-remitting, inflammatory skin disease characterized by intense itching, dry skin, redness, and exudation (1). Atopic dermatitis is one of the most common skin conditions and is more prevalent in children (15-38% across different age groups) than adults (2-10%), with onset often occurring in infancy (2,3). An estimated 70% of children with AD develop the condition before the age of 5 years (2).…”

Section: Introductionmentioning

confidence: 99%

Patient and caregiver preferences on treatment attributes for atopic dermatitis

Ervin

Crawford

Evans

et al. 2021

Journal of Dermatological Treatment

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Background:The expanding number of potential treatment options for atopic dermatitis (AD) highlights the need to better understand the treatment preferences of individuals with AD.Objective: This study identified attributes that most greatly influenced treatment preferences of adults/adolescents/caregivers of children with mild/moderate/severe AD. Methods: Adults (18 years), adolescents (12-17 years), and caregivers of children (2-11 years) with mild, moderate, or severe AD in the United States (US) and United Kingdom (UK) participated in semistructured interviews. Thematic analysis was used to identify and generate themes across the interview results describing the treatment attributes of greatest importance to participants. Results: Qualitative interviews were conducted with 35 adults, 35 caregivers, and 33 adolescent participants across both countries (n ¼ 103; US ¼ 51; UK ¼ 52) and all severity groups (mild ¼ 43; moderate ¼ 47; severe ¼ 13). The most important treatment attributes included efficacy (96.1%; speed and duration of symptom relief), mode of administration (66.0%; route of administration, frequency, and convenience), and side effects (55.3%, short-term, long-term, and general). Conclusions: Efficacy, mode of administration, and side effects were the most important attributes that influenced AD treatment preferences for patients and caregivers across different countries, ages, and disease severity. These results may assist patients/caregivers/clinicians in shared decision-making discussions to improve treatment adherence and outcomes.

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Section: Introductionmentioning

confidence: 99%

Patient and caregiver preferences on treatment attributes for atopic dermatitis

Ervin

Crawford

Evans

et al. 2021

Journal of Dermatological Treatment

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“…As part of the protocol development, a planning and feasibility study (U34 AR065739 01A1) was undertaken in 10 Meta-LARC clinics in five states that involved surveying parents of 652 children regarding the presence of an AD diagnosis. Key data generated from the planning project were the confirmation of high disease prevalence in primary care offices (24% by year 2) [23] and recognition that recommending emollients may not be as effective as physically providing emollients, given that 38% of parents still reported using a watery lotion even after receiving a brochure regarding the potential benefit of thicker emollients.…”

Section: Methodsmentioning

confidence: 99%

“…We anticipate a cumulative incidence of eczema of 24% at age 24 months without intervention [23]. To estimate at least 30% relative reduction in atopic dermatitis, we require 1044 dyads (522 per group) to achieve 80% power for a two-tailed test at the 0.05 level of significance with one midpoint analysis.…”

Section: Sample Sizementioning

confidence: 99%

A Community-based Assessment of Skin Care, Allergies, and Eczema (CASCADE): an atopic dermatitis primary prevention study using emollients—protocol for a randomized controlled trial

Eichner

Michaels

Branca

et al. 2020

Trials

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Background: Atopic dermatitis (AD) is a common, chronic skin disorder often beginning in infancy. Skin barrier dysfunction early in life serves as a central event in the pathogenesis of AD. In infants at high risk of developing AD, preventative application of lipid-rich emollients may reduce the risk of developing AD. This study aims to measure the effectiveness of this intervention in a population not selected for risk via a pragmatic, randomized, physicianblinded trial in the primary care setting. Methods: Infant-parent dyads are recruited from a primary care practice participating through one of four practicebased research networks in Oregon, Colorado, Wisconsin, and North Carolina. Eligible dyads are randomized to the intervention (daily use of lipid-rich emollient) or the control (no emollient) group (n = 625 infants in each) and are followed for 24 months. The primary outcome is the cumulative incidence of physician-diagnosed AD and secondary outcomes include caregiver-reported measures of AD and development of other atopic diseases. Data collection occurs via chart review and surveys, with no study visits required. Data will be analyzed utilizing intention-to-treat principles. Discussion: AD is a common skin condition in infants that affects quality of life and is associated with the development of other atopic diseases. If a safe intervention, such as application of lipid-rich emollients, in the general population effectively decreases AD prevalence, this could alter the guidance given by providers regarding routine skin care of infants. Because of the pragmatic design, we anticipate that this trial will yield generalizable results. Trial registration: ClinicalTrials.gov: NCT03409367. Registered on 11 February 2018.

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“…Therefore, the average of these prevalence data may be summarized as 14.8%. The prevalence of children from zero to five years old is significantly higher which was reported at 24% [ 65 ]. This trend is reasonable, according to previous studies and studies that will be discussed later which described younger children had higher prevalence compared to older children, adolescents, and adults.…”

Section: Global Epidemiology Of Admentioning

confidence: 99%

The Epidemiology and Global Burden of Atopic Dermatitis: A Narrative Review

Hadi

Tarmizi

Khalid

et al. 2021

Life

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The global epidemiology of atopic dermatitis (AD) in the current decade (2009–2019) has not been extensively reported. Epidemiological studies play an important role in presenting the risk factors of AD, as detailed prevalence and incidence data could demonstrate the burden of disease in the population of adults, adolescents, and children in different geographical regions. Thus, the primary objective of this review was to assess and summarize the epidemiological studies of the prevalence and incidence of AD in different age groups, focusing on data from studies published for 2009 to 2019. After a thorough literature search, six countries were identified from African, Asian, and European regions respectively, who published studies on AD. In contrast, only two studies were identified from Australia and New Zealand, three countries from North America and two from South America published AD studies, respectively. The highest prevalence of AD from included studies was noted among Swedish children with 34%, while the lowest prevalence was in Tunisian children with 0.65%; studies reporting incidence data were far less numerous. A common trend in the prevalence of AD was that children would have a higher prevalence as compared to adolescents and adults. The severity and morbidity of the disease showed variance with age, sex, socioeconomic characteristics, geographical location, and ethnicity. Environmental factors played an important role as causative agents in AD. The risk factors that were proven to cause and induce AD were skin barrier impairments due to FLG mutation, changes in the environment, and diet. FLG mutation may impair the skin barrier function by disruption of pH and hydration maintenance of the skin. Lastly, there were only a few studies on the incidence of AD in the 21st century. Therefore, epidemiological studies on childhood and adulthood AD in different continents are still needed, especially on the incidence of AD during adulthood.

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The Burden of Childhood Atopic Dermatitis in the Primary Care Setting: A Report from the Meta-LARC Consortium

Cited by 26 publications

References 38 publications

Patient and caregiver preferences on treatment attributes for atopic dermatitis

Patient and caregiver preferences on treatment attributes for atopic dermatitis

A Community-based Assessment of Skin Care, Allergies, and Eczema (CASCADE): an atopic dermatitis primary prevention study using emollients—protocol for a randomized controlled trial

The Epidemiology and Global Burden of Atopic Dermatitis: A Narrative Review

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