Complex treatment regimens, involving multiple drugs are increasingly used for the management of atopic dermatitis, shows a study published in the journal Dermatitis.1
The researchers found significant variation exists in prescribing patterns among doctors managing atopic dermatitis and that prescription of some drugs went against dermatology guidelines. For example, fewer than half of patients prescribed oral antibiotics had any evidence of infection.
To achieve a better understanding of patterns of outpatient prescribing and polypharmacy in U.S. patients with atopic dermatitis, the researchers mined data from the 1993–2015 National Ambulatory Medical Care Survey — a cross-sectional national survey implemented by the National Center for Health Statistics via the Centers for Disease Control and Prevention to analyze 128,300 pediatric and 623,935 adult outpatient visits.
They found considerable treatment heterogeneity and polypharmacy in the treatment of both children and adults with atopic dermatitis, which increased over time. Between 1993–2000 and 2011–2015 the proportion of visits to dermatologists yielding four or more prescriptions increased from 10% to 29%, and the proportion of patients receiving multiple prescriptions was higher in visits to primary care practitioners than to dermatologists.
While polypharmacy was highest in older patients aged 50 years or older as expected, it was also common in children and young adults. Adults had fairly low rates of outpatient appointments for their AD, the study found, suggesting those that sought outpatient care tended to have more severe disease requiring more aggressive treatment.