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Pediatr Dermatol. 2017 Jul;34(4):402-407. doi: 10.1111/pde.13157. Epub 2017 May 25.

An Atopic Dermatitis Management Algorithm for Primary Care Providers and Assessment of Its Usefulness as a Clinical Tool.

Author information

1
Department of Dermatology, Kaiser Permanente, San Jose, California.
2
Department of Dermatology, University of California, San Diego, San Diego, California.
3
Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, Florida.
4
Department of Pediatrics, University of California, San Francisco, San Francisco, California.
5
Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California.
6
Dell Children's Medical Center, Austin, Texas.
7
Dell Medical School, University of Texas, Austin, Texas.
8
Department of Dermatology, Stanford University, Stanford, California.
9
Department of Pediatrics, Stanford University, Stanford, California.
10
Department of Dermatology, University of California, San Francisco, San Francisco, California.

Abstract

BACKGROUND/OBJECTIVES:

There is a lack of primary care provider (PCP) understanding of atopic dermatitis (AD) treatments and topical steroid use. We designed an AD management algorithm for pediatric PCPs. We hypothesized that the algorithm would improve pediatric PCPs' knowledge of AD diagnosis and management.

METHODS:

Pediatric primary care resident and attending physicians at three residency programs were invited to participate in an electronic AD algorithm survey that contained demographic and 19 knowledge-based questions. Participants were randomized to intervention and control groups, with the intervention group receiving a short lecture and copy of our algorithm to use in an inpatient or outpatient setting for 2 months. Changes in scores between preintervention and postintervention surveys were compared.

RESULTS:

Of the 54 participants, those in the intervention group (n = 26) performed significantly better than those in the control group (n = 28) after controlling for pretest scores (β = 1.19 [95% confidence interval 0.07, 2.32], p = 0.04). The intervention group had a higher average score on the posttest knowledge questions (71% correct) than the control group (65% correct) (p = 0.06). The majority of physicians who received the algorithm agreed or strongly agreed that they liked using the algorithm.

CONCLUSION:

The use of a management algorithm improved physician knowledge about the diagnosis and treatment of AD and was well accepted by physicians. Use of this management algorithm may lead to better recognition and management of AD, particularly earlier recognition of and therapy for superinfection, improving treatment outcomes and quality of life for patients and families.

PMID:
28543716
DOI:
10.1111/pde.13157
[Indexed for MEDLINE]

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