title: Quality of health care of atopic eczema in Germany: results of the national health care study AtopicHealth.
abstract: BACKGROUND
  The successful treatment of atopic eczema (AE) should result in the improvement of both physical symptoms and patient's quality of life (QoL). This study was conducted using a sample of dermatologists throughout Germany. This is due to dermatologists being the main health care providers of AE.
  
  
  OBJECTIVE
  Obtaining reliable data on quality of care of AE from both the patient's and the physician's perspective.
  
  
  METHODS
  This cross-sectional study assessed: the individual clinical history; dermatology-specific QoL (DLQI); state of health (EQ-5d-VAS); treatments; burden caused by disease and treatment; patient-defined treatment benefit (PBI).
  
  
  RESULTS
  Data from 1678 adult patients (60.5% female, mean age: 38.4 ± 15.9) were analysed. The most frequently used treatments during the last five years were emollients (90.4%) and topical corticosteroids (85.5%). In this study, 75.8% of the patients felt only moderately or not at all impaired by their treatment. The mean DLQI (0 = minimum-30 = maximum QoL impairment) was 8.5 ± 6.5. The EQ-5d-VAS (100 = best possible) was 63.6 ± 22.0 on average. 26.6% reported suffering 'often' or 'every night' from sleeplessness due to severe itching. Mean PBI was 2.4 ± 1.1 (4 = maximum benefit).
  
  
  CONCLUSIONS
  This study provides first data on the health care of adults with AE in Germany at a national level and reveals the need for a more effective care. Whereas most patients consider their treatment-related burden as low, the daily burden of the disease seems to be high: one third reports sleeplessness due to itching which indicates insufficient therapeutic regimes in these cases. A better implementation of the German national guideline for AE and a systematic analysis of the difficulties causing its limited effects is needed.
authors.affiliation: IVDP - Institute for Health Services Research in Dermatology and Nursing, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Langenbruch
authors.forename: M
authors.initials: M
authors.lastname: Radtke
authors.forename: N
authors.initials: N
authors.lastname: Franzke
authors.forename: J
authors.initials: J
authors.lastname: Ring
authors.forename: R
authors.initials: R
authors.lastname: Foelster-Holst
authors.forename: M
authors.initials: M
authors.lastname: Augustin
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000188:drug therapy*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D011446:Prospective Studies; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D011788:Quality of Life; D011795:Surveys and Questionnaires