Consensus Defines Key Aspects of Atopic Dermatitis Flares

TOPLINE:

In a consensus survey study, participants with atopic dermatitis (AD) agreed on a patient-centered definition of AD flare, which most agreed would help when communicating with their healthcare providers (HCPs).

METHODOLOGY:

• To develop a patient-centered definition of AD flare, researchers used a modified eDelphi method, which involved a focus group and survey to reach consensus on key aspects of an AD flare.
• The focus group included 26 US adults aged ≥ 18 years with AD who had experienced a flare within the past 12 months. The survey was conducted among 631 adults with AD to validate the identified concepts and assess their agreement with the consensus statements.
• Participants rated 98 statements on a scale from 1 to 9, with consensus defined as at least 70% rating a statement as 7-9 and less than 15% rating it as 1-3.
• In focus groups, participants identified six key concepts for a patient-centered definition of flare, including changes from baseline, mental and emotional consequences, and physical changes in skin.

TAKEAWAY:

• The focus group reached consensus on 15 statements, and survey participants reached consensus on 12 of those statements defining an AD flare, with the highest agreement on symptoms taking more attention than normal, worsening of physical symptoms associated with AD, and worsening of itching associated with AD.
• The statement “acute worsening of symptoms of AD” was ranked as the most important, while “a worsening of physical symptoms” was ranked the least important.
• Most participants (79.7%) reported that prior definitions of AD flare did not resonate with them.
• More than half (52.9%) agreed with their HCP on what constitutes an AD flare, and the majority (77.6%) indicated that a patient-centered definition would be useful for communication with their HCP and for self-management.

IN PRACTICE:

“In this consensus survey study, we identified statements that are critical to the definition of an AD flare from the patient perspective,” the authors wrote. These findings, they added, “may be useful in clinical practice to improve communication between patients and HCPs who may be using the term flare without a mutual understanding of its meaning” and “may also be applied to the development of outcome measures focused on AD flares, which is an important treatment outcome for people with AD.”

SOURCE:

The study was led by Aaron M. Drucker, MD, ScM, of the Division of Dermatology, Department of Medicine, University of Toronto, Ontario, Canada, and was published online on September 11 in JAMA Dermatology.

LIMITATIONS:

Participants had higher-than-average knowledge about AD, and the study’s findings may not be generalizable to all people with AD. The study included a higher proportion of moderate to severe AD cases than the general population, which may introduce responder bias. The findings may not be applicable to children, caregivers, or individuals in other countries.

DISCLOSURES:

This work was supported by a grant to the National Eczema Association from Pfizer. Drucker disclosed received compensation from the British Journal of Dermatology, American Academy of Dermatology, and Canadian Dermatology Today, and consultant fees from the National Eczema Association and Canadian Agency for Drugs and Technologies in Health. Another author reported receiving personal fees from pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.