NPS MedicineWise, Sydney, New South Wales, Australia.
Australian National University, Canberra, Australian Capital Territory, Australia.
Australas J Dermatol. 2020 Aug;61(3):e319-e327. doi: 10.1111/ajd.13268. Epub 2020 Mar 15.
BACKGROUND/OBJECTIVES: The prevalence of atopic dermatitis (AD) has increased significantly in industrialised countries in recent decades but data about the incidence or prevalence of AD in Australia are sparse. We aimed to determine the prevalence and incidence of AD among patients seen in Australian general practice and the use of specified medicines.
This was a cross-sectional study of 2.1 million patients attending 494 general practices in the MedicineInsight program from 1 January 2017 to 31 December 2018. We assessed the prevalence (lifetime and current), incidence, management and severity of AD.
The lifetime (ever diagnosed) prevalence of AD in this general practice population was 16.4% and was greater in females (17.3%) than males (15.3%). One in five patients with AD were classified as having moderate-to-severe disease. Prevalence over the last two years was 6.3%. The incidence of AD in 2018 was 2.0% and was greater in females (2.2%) and for patients aged 0-4 years (3.9%). Patients with AD had an increased risk of insomnia, anxiety and depression, compared to those with no recorded AD. For AD patients, topical corticosteroids were the most commonly prescribed AD medication (36.5%) and topical calcineurin inhibitors the least (0.1%), with systemic corticosteroids (15.6%) more commonly prescribed than other immunosuppressants (0.9%).
Our findings provide important insights into the epidemiology of AD and its management in Australian general practice. This information is likely to be useful in planning effective interventions to support GPs in the optimal management of patients with AD.
背景/目的:在过去几十年中,工业化国家的特应性皮炎(AD)患病率显著增加,但澳大利亚 AD 的发病率或患病率数据却很少。我们旨在确定澳大利亚普通诊所患者中 AD 的患病率和发病率以及特定药物的使用情况。
这是一项横断面研究,纳入了 2017 年 1 月 1 日至 2018 年 12 月 31 日期间参加 MedicineInsight 计划的 494 家普通诊所的 210 万名患者。我们评估了 AD 的患病率(终生和当前)、发病率、管理和严重程度。
该普通诊所人群中 AD 的终生(曾诊断)患病率为 16.4%,女性(17.3%)高于男性(15.3%)。五分之一的 AD 患者被归类为中重度疾病。过去两年的患病率为 6.3%。2018 年 AD 的发病率为 2.0%,女性(2.2%)和 0-4 岁患者(3.9%)更高。与无 AD 记录的患者相比,AD 患者有更高的失眠、焦虑和抑郁风险。对于 AD 患者,局部皮质类固醇是最常开的 AD 药物(36.5%),而局部钙调神经磷酸酶抑制剂最少(0.1%),全身皮质类固醇(15.6%)比其他免疫抑制剂(0.9%)更常开。
我们的研究结果提供了 AD 在澳大利亚普通诊所的流行病学和管理方面的重要见解。这些信息可能有助于规划有效的干预措施,以支持全科医生对 AD 患者的最佳管理。