A European Academy of Dermatology and Venereology study explored the pathway from dermatologic consult to diagnosis to treatment and outcomes in the health care system.
A study1 recently published in the Journal of the European Academy of Dermatology and Venereology sought to examine the relationship between patients and their respective journeys through the dermatology and health care systems. The study, closely looking at a cohort of patients spanning 27 European countries, found that just over a quarter (30.3%) of patients reported receiving a dermatology consult within the previous 2 years.
Between November 10, 2020, and August 5, 2021, investigators conducted the multinational, cross-sectional study using framework from the European Academy of Dermatology and Venereology’s “Burden of skin diseases in Europe” study.2 Investigators noted that research and data closely examining the dermatology patient journey has been limited and scarce.
Participants (n=44,689) were adult patients from 24 European Union (EU) and 3 non-EU countries, including Norway, Switzerland, and the United Kingdom. Upon completing a multi-module questionnaire inquiring about patients’ dermatologic histories, diagnosed skin conditions, and additional and/or unpleasant skin sensations, researchers gathered information related to the demographic, clinical, and health care of all patients. In cases of patients experiencing multiple or overlapping skin conditions, investigators asked participants to respond in accordance with their most bothersome skin concern.
During the 12 months leading up to the study, approximately 43.4% reported having at least 1 skin condition or disease, excluding skin or mole checks. In estimating dermatologic visits prior to study inclusion, half of participants reported visiting a dermatologist within 5 years prior. This number steadily decreased over time, with 30.3% of participants reporting a visit within the most recent 2 years, and 18.4% receiving a dermatologic consultation in the most recent 12 months.
Approximately 33.1% of participants admitted to having never received a dermatologic consultation.
The most common reasons for visiting dermatologists and receiving a dermatologic consultation included mole and skin checks (22.3%), recurrent or long-lasting skin disease (16.2%), and acute or transient skin problems (12.0%).
In order of prevalence, the most commonly self-reported skin conditions among participants included fungal skin infections, alopecia, acne, and atopic dermatitis or eczema. The least commonly self-reported skin conditions included rosacea and skin cancer. Participants also reported diagnoses of psoriasis and sexually transmitted diseases (STD) affecting their skin.
Investigators also explored the reasons for not consulting dermatologic professionals by diagnosed skin condition. Most commonly, patients with alopecia, acne, and fungal skin infections did not consult dermatologists. More than half of participants (53.7%) of patients with alopecia reported that they felt their condition was not worrisome enough to consult a health care provider, and 39.7% of patients with psoriasis had already consulted a dermatologist and felt they knew how to best manage their condition on their own. Patients with acne, atopic dermatitis, fungal infections, rosacea, or STDs most commonly felt their condition was manageable either on their own or with the support of loved ones.
A key limitation of this study, according to study authors, was the method of self-reporting used to collect data. However, investigators felt the nature of this data collection was crucial to obtaining data more representative of the general population.
"Mapping patient journeys may provide important insight into the value of health care services,” study authors wrote.“Based on patients' experiences, providers can address the needs of the patient with targeted interventions. Streamlining the patient journey by providing to guidelines for primary and secondary care across specialisms can improve patients' outcomes, and reduce diagnostic delay and health care expenses.”
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