Eczema: How symptom improvement affects patient satisfaction

• Atopic dermatitis, the most prevalent type of eczema, can cause itchy skin and rashes that impair a person’s quality of life.
• Topical therapy, such as corticosteroid creams, can help alleviate symptoms of mild-to-moderate atopic dermatitis, but uncontrolled moderate-to-severe symptoms may also require oral or injectable drugs.
• A number of oral and injectable drugs are available for moderate-to-severe atopic dermatitis and determining factors influencing patient outcomes can help inform physicians’ decisions about treatments for the management of this skin condition.
• A recent study shows that patients with moderate-to-severe dermatitis who experienced the most rapid and significant reduction in itch levels and a greater reduction in affected body area were more likely to be satisfied with the treatment.

Atopic dermatitis is the most common form of eczema. It affects 16 million adults in the United States.

Depending on the severity, atopic dermatitis can negatively impact a person’s health and quality of life.

Numerous treatments are available for moderate-to-severe atopic dermatitis, but there is a lack of sufficient data comparing these treatments.

A study, which hasn’t been published yet in a peer review journal, was presented at the 5th Annual Revolutionizing Atopic Dermatitis Conference (RAD 2023).

In it, researchers reported that people were more likely to express satisfaction with treatments that produced the lowest levels of itch and the quickest onset of reduction in itchiness as well as ones that led to the largest decline in skin surface affected by atopic dermatitis.

Using eczema treatment data

Experts say these criteria that influence patient satisfaction with treatments for moderate-to-severe dermatitis can be used to inform shared decision-making in the clinic.

“The study’s findings highlight the importance of considering both the degree and speed of symptom improvement in atopic dermatitis treatment. As dermatologists, we recognize that addressing these factors is vital in providing optimal care and meeting our patients’ expectations,” said Dr. Maham Khan, a consultant dermatologist at the Cadogan Clinic in London who was not involved in the study.

“By focusing on treatments that not only alleviate symptoms but also deliver rapid and substantial relief from itchiness while improving the appearance of the skin, we can significantly enhance patient satisfaction and overall well-being,” Khan told Medical News Today.

“In conclusion, as dermatologists, we are inspired by these study findings, which reaffirm our commitment to patient-centered care,” he added. “By taking into account the valuable insights provided by our patients, we can make more informed treatment decisions and provide tailored therapies that bring about satisfaction, hope, and improved outcomes for individuals living with moderate-to-severe atopic dermatitis.”

Treatments for atopic dermatitis

Atopic dermatitis is a chronic inflammatory skin condition that causes dry and itchy skin and painful rashes. These symptoms of atopic dermatitis can disrupt sleep and adversely impact a person’s quality of everyday life.

The most common treatment for atopic dermatitis involves topical therapy, including corticosteroid creams and ointments. However, many patients either stop responding to treatments such as corticosteroids or show adverse reactions to these topical medications, leading to discontinuation of treatment.

Healthcare providers may also prescribe oral or injectable drugs along with topical medications to alleviate moderate-to-severe eczema. These systemic therapies include corticosteroids and drugs or antibodies such as dupilumab to modify the immune system.

Clinical trials generally compare the efficacy of a specific therapeutic with a placebo, and the lack of sufficient data on head-to-head comparisons makes decision-making challenging for clinicians. In addition to the multitude of treatment pathways, patients with atopic dermatitis also show considerable variation in the presentation of symptoms.

“Numerous systemic therapies are currently available to treat moderate-to-severe atopic dermatitis,” said Dr. Melinda Gooderham, a study author and a professor at Queen’s College in Canada.

“However, more data evaluating patient satisfaction with various characteristics of these treatments are needed to inform shared decision-making between physicians and their patients,” she told Medical News Today.

Factors influencing patient satisfaction

In their study, the researchers surveyed 186 adults with moderate-to-severe eczema to assess the relationship between self-reported symptom changes after treatment and treatment satisfaction.

These patients were using at least one medication for eczema at the time of the survey with topical therapy being the most commonly used treatment.

The participants reporting no or very low levels of itch or pruritus in the 24-hour period before the survey were more likely to express high levels of satisfaction with treatment than those experiencing the highest levels of itchiness.

The researchers then interviewed the participants about the time of noticeable reductions in itch levels, categorizing patients into those who showed itch reduction in 1-6 days, 7-13 days, or 14 days and later.

The people who showed noticeable itch reduction within 1-6 days had a higher likelihood of expressing satisfaction with their treatment than those who started to experience such an improvement at 14 days or later.

Lastly, individuals who showed a greater reduction in the affected body area were more likely to report higher levels of treatment satisfaction.

The researchers noted that the survey did not include questions about adverse effects associated with the treatments and, therefore, these results must be interpreted with caution.

“This study underscores the need for continued research and development in systemic therapies for atopic dermatitis,” said Khan. “By further understanding and addressing our patients’ specific desires and concerns, we can work towards developing even more effective treatments that align with their preferences and aspirations.”

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