Management and Referral Patterns in Pediatric Atopic Dermatitis: A Survey of Pediatric Healthcare Professionals

Main Article Content

Courtney Nicole Bernett
Emma Hignett
Pearl Kwong

Keywords

atopic dermatitis, pediatric

Abstract

Background: The incidence of pediatric atopic dermatitis (AD) has continued to increase worldwide and pediatric healthcare providers (PHPs) are typically the initial healthcare provider tasked with management of this disease. The consequences of inadequately managed AD and misdiagnosed food allergies are devastating for patients and their families, and the financial burden associated with these scenarios can be overwhelming.


Objective: To assess the management and referral patterns of pediatric AD patients by PHPs in the Jacksonville, Florida (FL) area.


Methods: An online electronic survey was distributed to 70 PHPs using Survey Monkey©.  Data was collected over a 6-week period. The survey yielded a sample size of 28.


Results: Most participants were physicians (92.8%), with an average of 21.75 years in practice. Just over half (53%) of PHPs were aware of the American Academy of Dermatology (AAD) Guidelines of care for the management of AD. Dermatologists were the initial referral choice for AD management in 2/3, while 1/3 indicated preference for an allergist. Diet alteration was used by 14.3% as an initial AD management step and 35.7% tried elimination diets prior to referral to an allergist. Referral to specialists were low with 75% PHPs referring <25 % of their AD patients to dermatology.


Conclusion: With the number of outpatient AD visits increasing amongst PHPs, knowledge of management guidelines, in-depth understanding of appropriate use and limitations of elimination diets and food allergen testing, and referral to specialists suitable for management of this cutaneous disorder are imperative, but found to be highly variable.

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