Prevalence, incidence and management of atopic dermatitis in Australian general practice using routinely collected data from MedicineInsight

Abstract

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. Methods: 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. Results: 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%). Conclusions: 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.

Prevalence and Associations of General Practice Registrars’ Management of Atopic Dermatitis: A Cross-Sectional Analysis from the Registrar Clinical Encounters in Training Study

“…There are 4 classes of TCS according to potency [31], grouped from mild to very potent. Chidwick et al found that GPs were most likely to prescribe potent TCS [7]. In contrast, we found that registrars were most likely to prescribe TCS of mild or moderate potency.…”

“…AD persists in teenagers and adults in approximately 50% of pediatric patients [5]. It is characterized by chronic inflammation and pruritis [6], and sufferers encounter a relapsing and remitting disease course [7]. Carrying the heaviest global burden of skin disease [8],…”

“…AD is associated with significant physical and mental health sequelae, including effects on mood, sleep, and quality of life [7,9,10]. Childhood AD also profoundly impacts the financial, social, and psychological wellbeing of their families [11,12].…”

“…As a common primary health presentation [7,17] general practice (GP) registrars may encounter AD throughout their training. In Australia, general practice training operates through an in-practice apprenticeship model [18][19][20].…”

Filaggrin gene polymorphisms are associated with atopic dermatitis in women but not in men in the Caucasian population of Central Russia

“…Atopic dermatitis (AD), also called eczema, is a chronic, relapsing, pruritic, inflammatory skin disease [ 1 ]. The prevalence of AD is high, up to 16% in the general practice population (lifetime ever diagnosed) with about 20% of the affected individuals having moderate to severe symptoms [ 2 ]. AD is characterized by chronic lichenified or excoriated plaques occurring in typical areas, such as the head, neck, flexural areas, and extensive itching lesions [ 3 ].…”