title: Translating Atopic Dermatitis Management Guidelines Into Practice for Primary Care Providers.
abstract: Atopic dermatitis affects a substantial number of children, many of whom seek initial treatment from their pediatrician or other primary care provider. Approximately two-thirds of these patients have mild disease and can be adequately managed at the primary care level. However, recent treatment guidelines are written primarily for use by specialists and lack certain elements that would make them more useful to primary care providers. This article evaluates these recent treatment guidelines in terms of evaluation criteria, treatment recommendations, usability, accessibility, and applicability to nonspecialists and integrates them with clinical evidence to present a streamlined severity-based treatment model for the management of a majority of atopic dermatitis cases. Because each patient's situation is unique, individualization of treatment plans is critical as is efficient communication and implementation of the plan with patients and caregivers. Specifically, practical suggestions for individualizing, optimizing, implementing, and communicating treatment plans such as choosing a moisturizer formulation, avoiding common triggers, educating patients/caregivers, providing written treatment plans, and scheduling physician follow-up are provided along with a discussion of available resources for patients/caregivers and providers.
authors.affiliation: Departments of Pediatrics and Dermatology, School of Medicine, University of California, San Diego, San Diego, California; leichenfield@rchsd.org.
authors.forename: Lawrence F
authors.initials: LF
authors.lastname: Eichenfield
authors.affiliation: Division of Pediatric Allergy-Immunology, Department of Pediatrics, National Jewish Health and School of Medicine, University of Colorado Denver, Colorado;
authors.forename: Mark
authors.initials: M
authors.lastname: Boguniewicz
authors.affiliation: Departments of Dermatology, and.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Simpson
authors.affiliation: Department of Family and Community Medicine, Sydney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania;
authors.forename: John J
authors.initials: JJ
authors.lastname: Russell
authors.affiliation: National Eczema Association, San Rafael, California;
authors.forename: Julie K
authors.initials: JK
authors.lastname: Block
authors.affiliation: Department of Dermatology, Pathology, and Public Health Sciences, Wake Forest Baptist Health, Winston-Salem, North Carolina;
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
authors.affiliation: Department of Dermatology.
authors.forename: Adele R
authors.initials: AR
authors.lastname: Clark
authors.affiliation: Nursing, Oregon Health & Science University, Portland, Oregon;
authors.forename: Susan
authors.initials: S
authors.lastname: Tofte
authors.affiliation: VRx, Salt Lake City, Utah; and.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Dunn
authors.affiliation: Departments of Dermatology and Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Paller
mesh_terms: D017028:Caregivers; D003876:Dermatitis, Atopic / Q000628:therapy*; D019317:Evidence-Based Medicine; D005190:Family; D019983:Guideline Adherence; D006801:Humans; D010347:Patient Care Planning; D010353:Patient Education as Topic; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D011320:Primary Health Care