Patient perspectives on the management of atopic dermatitis.
BACKGROUND
Atopic dermatitis (AD) is increasingly common, with a point prevalence of more than 30% in some countries, and is characterized by visible skin lesions and intense itching.


OBJECTIVE
The International Study of Life with Atopic Eczema (ISOLATE) is the first large-scale study to assess the effect of AD on the lives of patients and society, how patients and caregivers manage the condition, and how well patients and caregivers currently believe that AD is controlled.


METHODS
Two thousand two patients (>13 years) and caregivers of children (2-13 years) with moderate-to-severe AD randomly selected from 8 countries underwent standardized telephone interviews using questions developed in collaboration with national eczema patient groups and physicians.


RESULTS
During each year, patients spend, on average, 1 of 3 days in flare. The majority of patients receive prescription topical corticosteroids to treat flares; however, 49% of respondents are concerned about using these agents. On average, patients and caregivers delay initiating treatment for 7 days after onset of a flare. Only 24% of patients and caregivers feel confident they can manage AD flares adequately. Seventy-five percent of caregivers and patients feel that being able to effectively control AD would be the single most important improvement to their or their child's quality of life. The avoidable secondary economic cost of AD is estimated at 2 billion Euro per year across the European Union.


CONCLUSIONS
ISOLATE highlights the need to improve patients' control of AD to reduce the significant effect this condition has on the patient and society.


CONCLUSIONS
ISOLATE shows that patients with AD are untreated for half the time they are in flare, and thus there is an urgent need for physicians to ensure that the patients are educated and confident in using medication as prescribed to gain disease control.
Zuberbier
Torsten
T
Department of Dermatology and Allergy, Allergy Centre Charité, Charité-Universitätsmedizin Berlin, Schumannstrasse 20-21, D-10117 Berlin, Germany. torsten.zuberbier@charite.de
Orlow
Seth J
SJ
Paller
Amy S
AS
Taïeb
Alain
A
Allen
Roger
R
Hernanz-Hermosa
José M
JM
Ocampo-Candiani
Jorge
J
Cox
Margaret
M
Langeraar
Joanne
J
Simon
Jan C
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic