Multidisciplinary atopic dermatitis program: A novel approach to managing difficult‐to‐control atopic dermatitis patients

Author:

Tracy Alexis1,Loop Lauren2ORCID,Bhatti Safiyyah1,Anterasian Christine3,Kellogg Caitlyn1,Smiley Kathryn1,Wu Alyssa1,Geng Bob2,Eichenfield Lawrence4

Affiliation:

1. Division of Allergy and Immunology, Division of Pediatric Dermatology, Departments of Dermatology and Pediatrics University of California, San Diego, and Rady Children's Hospital San Diego California USA

2. Department of Pediatrics, Division of Allergy and Immunology University of California, San Diego and Rady's Children's Hospital San Diego California USA

3. Department of Pediatrics, Division of Pediatric and Infectious Diseases University of Washington and Seattle Children's Hospital Seattle Washington USA

4. Division of Pediatric Dermatology, Departments of Dermatology and Pediatrics University of California, San Diego and Rady Children's Hospital San Diego California USA

Abstract

AbstractBackground/ObjectivesDisease improvement for difficult‐to‐control pediatric atopic dermatitis may be more challenging to achieve when directed by single specialties due to disjointed and conflicting dialogue with patients.MethodsThe Multidisciplinary Atopic Dermatitis Program (MADP) was developed through collaborations with the Rady Children's Hospital and UC San Diego Health Divisions of Dermatology, Allergy & Immunology and Clinical Pharmacy, to create team‐based evaluation and management of children and adolescents with atopic dermatitis (AD). The MADP allows concurrent, comprehensive evaluations by multiple specialists to develop treatment plans. The program includes extensive patient education to support shared decision making, incorporating patient and family's perspectives along with those of clinical experts into their care. Objective severity measures and patient reported outcome data were collected, along with assessment of patient and family satisfaction with the MADP.ResultsData showed significant improvement in AD severity as assessed by providers, patients and families by the first follow‐up visit. BSA mean percentage decreased by up to 56% by the 7th visit, and pruritus (NRS), CLDQI and POEM mean scores decreased by more than 4 points, 12 points, and over 11 points, respectively. After management was initiated in the MADP, 72.73% of patients achieved an EASI 50 and 47.73% achieved an EASI 75 from a baseline mean of 21.7. Patients who continued in clinic beyond the second visit showed further clinically significant decreases in disease measures.ConclusionsThe multidisciplinary approach shows success in the treatment of difficult‐to‐control AD patients with improvements in clinician and patient reported outcome measures.

Funder

Sanofi

Pfizer

Publisher

Wiley

Reference20 articles.

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2. National Eczema Association.National Eczema Association Home Page. Accessed September 1 2023.https://nationaleczema.org/

3. Association of shared decision-making on patient-reported health outcomes and healthcare utilization

4. Center of Evidence Based Dermatology University of Nottingham.EASI for clinical signs. Accessed September 1 2023.http://www.homeforeczema.org/research/easi-for-clinical-signs.aspx

5. International Eczema Council.International Eczema Council Home Page. Accessed September 1 2023.https://www.eczemacouncil.org

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