Willems Anneliese, Tapley Amanda, Fielding Alison, Tng Er Tsing Vivian, Holliday Elizabeth G, van Driel Mieke L, Ball Jean I, Davey Andrew R, Patsan Irena, FitzGerald Kristen, Spike Neil A, Magin Parker J
Eastern Victoria General Practice Training, Regional Training Organisation, Hawthorn, Victoria, Australia.
University of Melbourne, Department of General Practice and Primary Health Care, Berkeley Street, Carlton, Victoria, Australia.
Dermatol Pract Concept. 2021 Sep 1;11(4):e2021128. doi: 10.5826/dpc.1104a128. eCollection 2021 Sep.
Atopic dermatitis (AD) is a chronic inflammatory condition which imposes substantial burden upon patients and their families. As a frequent primary care presentation, general practice (GP) trainees must develop adequate skills in AD diagnosis and management.
We aimed to explore the prevalence and associations of GP registrars' management of patients with AD.
This study used data from the Registrar Clinical Encounters in Training (ReCEnT) project, an ongoing cohort study of the clinical and educational experience of Australian GP registrars. Registrar, patient, and consultation factors were independent variables in multivariable logistic regression with outcome factor 'diagnosis/problem being AD'.
From 2010-2019, 2,783 registrars (96% response rate) provided data from 381,180 consultations. AD was encountered in 0.6% of consults. AD was more likely to be seen in patients aged 0-1 years and patients from a non-English speaking background. AD was less likely to be seen in Aboriginal or Torres Strait Islander patients. Learning goals were more likely to be generated for AD and these consultations were associated with registrars seeking information or assistance. AD was strongly associated with a medication being prescribed, of which the most prescribed medications were mild or moderate potency topical corticosteroids.
Our findings suggest that, similar to other dermatological presentations, registrars find AD challenging to manage. There may be some gaps in AD management knowledge and application.
特应性皮炎（AD）是一种慢性炎症性疾病，给患者及其家庭带来了沉重负担。作为初级保健中常见的病症，全科医学（GP）实习生必须掌握足够的AD诊断和管理技能。
我们旨在探讨GP注册医生对AD患者管理的患病率及相关性。
本研究使用了培训注册医生临床诊疗记录（ReCEnT）项目的数据，这是一项对澳大利亚GP注册医生临床和教育经验的正在进行的队列研究。注册医生、患者和诊疗因素是多变量逻辑回归中的自变量，结果因素为“诊断/问题为AD”。
2010年至2019年，2783名注册医生（回复率96%）提供了381180次诊疗的数据。0.6%的诊疗中遇到了AD。AD在0至1岁的患者以及非英语背景的患者中更常见。原住民或托雷斯海峡岛民患者中AD的发生率较低。针对AD更有可能制定学习目标，并且这些诊疗与注册医生寻求信息或帮助有关。AD与开具药物密切相关，其中最常开具的药物是轻度或中度效力的外用糖皮质激素。
我们的研究结果表明，与其他皮肤病表现类似，注册医生发现AD管理具有挑战性。在AD管理知识和应用方面可能存在一些差距。
