380 Differences in topical corticosteroid prescribing patterns between primary care providers and dermatologists for atopic dermatitis

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease. Many patients with AD seek care from both primary care physicians and dermatologists. However, little is known regarding topical corticosteroid prescribing patterns between these two specialties. We sought to determine if differences exist in the topical corticosteroid (TCS) prescribing patterns between dermatologists, family medicine physicians, and internal medicine physicians. We conducted a population-based, cross-sectional analysis using data from the National Ambulatory Medical Care Survey (NAMCS) from 2006 to 2016. There were 5,071,158 (weighted) outpatient AD visits between 2006 and 2016 for adults who were seen by physicians from family medicine, internal medicine, and dermatology. There was not a statistically significant difference in the rate of TCS prescriptions for AD between family medicine physicians and dermatologists (39.1% vs. 52.2%; p¼0.27). However, family medicine physicians had a higher rate of prescribing TCS for AD than internal medicine physicians (39.1% vs. 5.1%; p¼0.002). Dermatologists had a significantly higher rate of prescribing TCS for AD compared to internal medicine physicians (52% versus 5%; p<0.001). Our findings demonstrate that dermatologists prescribe topical corticosteroids for atopic dermatitis more frequently compared to internal medicine physicians but not in comparison to family medicine physicians. It is important to understand the key differences in practice patterns among medical specialties for AD care and identify educational gaps.