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J Eur Acad Dermatol Venereol. 2014 Jun;28(6):719-26. doi: 10.1111/jdv.12154. Epub 2013 Apr 5.

Quality of health care of atopic eczema in Germany: results of the national health care study AtopicHealth.

Author information

  • 1IVDP - Institute for Health Services Research in Dermatology and Nursing, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.

Abstract

BACKGROUND:

The successful treatment of atopic eczema (AE) should result in the improvement of both physical symptoms and patient's quality of life (QoL). This study was conducted using a sample of dermatologists throughout Germany. This is due to dermatologists being the main health care providers of AE.

OBJECTIVES:

Obtaining reliable data on quality of care of AE from both the patient's and the physician's perspective.

METHODS:

This cross-sectional study assessed: the individual clinical history; dermatology-specific QoL (DLQI); state of health (EQ-5d-VAS); treatments; burden caused by disease and treatment; patient-defined treatment benefit (PBI).

RESULTS:

Data from 1678 adult patients (60.5% female, mean age: 38.4 ± 15.9) were analysed. The most frequently used treatments during the last five years were emollients (90.4%) and topical corticosteroids (85.5%). In this study, 75.8% of the patients felt only moderately or not at all impaired by their treatment. The mean DLQI (0 = minimum-30 = maximum QoL impairment) was 8.5 ± 6.5. The EQ-5d-VAS (100 = best possible) was 63.6 ± 22.0 on average. 26.6% reported suffering 'often' or 'every night' from sleeplessness due to severe itching. Mean PBI was 2.4 ± 1.1 (4 = maximum benefit).

CONCLUSIONS:

This study provides first data on the health care of adults with AE in Germany at a national level and reveals the need for a more effective care. Whereas most patients consider their treatment-related burden as low, the daily burden of the disease seems to be high: one third reports sleeplessness due to itching which indicates insufficient therapeutic regimes in these cases. A better implementation of the German national guideline for AE and a systematic analysis of the difficulties causing its limited effects is needed.

PMID:
23560545
DOI:
10.1111/jdv.12154
[PubMed - indexed for MEDLINE]
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