Langenbruch Anna, Andrees Valerie, Scherer Martin, Augustin Matthias
Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
J Dtsch Dermatol Ges. 2024 Dec;22(12):1620-1629. doi: 10.1111/ddg.15529. Epub 2024 Sep 3.
Epidemiological studies on the health care of patients with atopic dermatitis (AD) in dermatological treatment in Germany indicate no improvements within 10 years. In addition to dermatologists, general practitioners (GPs) are particularly involved in AD treatment. This study analyzed the health care situation of adult patients with AD by GPs.
The cross-sectional questionnaire survey "PsoADA" was conducted from 2019 to 2021 in general practices throughout Germany and the results were compared with previous data from dermatology care (AtopicHealth2, 2017-19).
Among 150 patients (mean age: 40 years, 62.2% female), 39.2% received additional treatment by a dermatologist (GP+D). 20.7% of GP+D and 5.7% of patients in GP treatment only (GP only) had severe AD (p < 0.01, AtopicHealth2: 27.6%). Major limitations in quality of life were reported by 31.0% (GP+D) versus 3.4% (GP only) (p < 0.001, AtopicHealth2: 31.6%). Most patients received topicals, mainly glucocorticosteroids. Calcineurin inhibitors were currently administered by 2.7% (PsoADA total). Patient education was reported by 5.7% (PsoADA total).
A considerable proportion of patients with AD in GP care shows poor outcomes, as has been observed in dermatological care - possibly due to the lack of use of modern systemic therapy.
德国皮肤病治疗中关于特应性皮炎(AD)患者医疗保健的流行病学研究表明,10年内并无改善。除皮肤科医生外,全科医生(GPs)也特别参与到AD治疗中。本研究分析了全科医生对成年AD患者的医疗保健情况。
2019年至2021年在德国各地的全科诊所进行了横断面问卷调查“PsoADA”,并将结果与之前皮肤科护理的数据(AtopicHealth2,2017 - 19年)进行比较。
在150名患者(平均年龄:40岁,62.2%为女性)中,39.2%接受了皮肤科医生的额外治疗(全科医生 + 皮肤科医生)。全科医生 + 皮肤科医生组中有20.7%的患者以及仅接受全科医生治疗(仅全科医生)的患者中有5.7%患有重度AD(p < 0.01,AtopicHealth2:27.6%)。报告生活质量存在重大限制的患者在全科医生 + 皮肤科医生组中占31.0%,而在仅全科医生组中占3.4%(p < 0.001,AtopicHealth2:31.6%)。大多数患者接受局部用药,主要是糖皮质激素。目前使用钙调神经磷酸酶抑制剂的患者占2.7%(PsoADA总体)。报告接受患者教育的占5.7%(PsoADA总体)。
全科医生护理的AD患者中有相当一部分预后不佳,这与皮肤科护理中观察到的情况一样——可能是由于缺乏现代系统疗法的使用。