Treatment and referral patterns of patients with atopic dermatitis from the Danish primary care system to the tertiary care system (2024)

Danielsen, A. K., Frølunde, A. S., Heilskov, S., Deleuran, M., Laust Thomsen, J., & Vestergaard, C. (Accepted/In press). Treatment and referral patterns of patients with atopic dermatitis from the Danish primary care system to the tertiary care system. JEADV Clinical Practice. https://doi.org/10.1002/jvc2.374

Danielsen, Anna Kathrine ; Frølunde, Anne Sofie ; Heilskov, Sofine et al. / Treatment and referral patterns of patients with atopic dermatitis from the Danish primary care system to the tertiary care system. In: JEADV Clinical Practice. 2024.

@article{0533857dba2645c489c0e0fc4300dc03,

title = "Treatment and referral patterns of patients with atopic dermatitis from the Danish primary care system to the tertiary care system",

abstract = "Background: Patients with atopic dermatitis (AD) are mostly managed by general practitioners (GPs) and practicing dermatologists (PDs) in Denmark. In cases of severe and refractory AD, the primary physician can refer the patient to a specialised dermatology department. Objectives: Aim of the study was to investigate treatment at the time of referral to a specialised dermatology department and the cause stated by the GP in a Danish cohort of AD patients referred to the Department of Dermatology, Aarhus University Hospital from 2019 to 2021. Methods: One hundred and thirty cases were randomly selected via diagnosis codes for AD. Information regarding the cause for referral and treatment given at time of referral was obtained from medical records. 18 cases were excluded due to missing referral in the patients' medical records, other diagnosis than AD or treatment initiation before 2019. The final cohort consisted of 112 cases. Differences between patients referred from GP and PD were analysed with Fisher's exact test. Results: Most cases were referred by PDs (45.5%) and GPs (24.1%). GPs primarily referred due to acute flare-ups in need of treatment (40.7%), and PDs due to lacking disease control (64.7%), (p-values < 0.0018). GPs generally included more descriptive information in their referrals than PDs, however, only the difference in mentioning sleep disturbance was significant (p-value = 0.0144). Topical corticosteroids were the preferred treatments before referral regardless of the referring doctor, with no statistical differences. Topical calcineurin inhibitors were significantly more used among PD-referred patients compared to GP-referred patients (p-value = 0.0018). Systemic therapy was initiated in 45 patients (40.2%) at the tertiary hospital with no differences between referral from either GPs or PDs. Conclusions: The study identified few differences in the referral pattern of AD to a tertiary treatment center from GPs and PDs. No major deviations from Danish guidelines were found.",

keywords = "atopic dermatitis, general practice, practicing dermatologist, referral pattern",

author = "Danielsen, {Anna Kathrine} and Fr{\o}lunde, {Anne Sofie} and Sofine Heilskov and Mette Deleuran and {Laust Thomsen}, Janus and Christian Vestergaard",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors. JEADV Clinical Practice published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.",

year = "2024",

doi = "10.1002/jvc2.374",

language = "English",

journal = "JEADV Clinical Practice",

issn = "2768-6566",

publisher = "Wiley",

}

Danielsen, AK, Frølunde, AS, Heilskov, S, Deleuran, M, Laust Thomsen, J & Vestergaard, C 2024, 'Treatment and referral patterns of patients with atopic dermatitis from the Danish primary care system to the tertiary care system', JEADV Clinical Practice. https://doi.org/10.1002/jvc2.374

Treatment and referral patterns of patients with atopic dermatitis from the Danish primary care system to the tertiary care system. / Danielsen, Anna Kathrine; Frølunde, Anne Sofie; Heilskov, Sofine et al.
In: JEADV Clinical Practice, 2024.

Research output: Contribution to journal › Journal article › Research › peer-review

TY - JOUR

T1 - Treatment and referral patterns of patients with atopic dermatitis from the Danish primary care system to the tertiary care system

AU - Danielsen, Anna Kathrine

AU - Frølunde, Anne Sofie

AU - Heilskov, Sofine

AU - Deleuran, Mette

AU - Laust Thomsen, Janus

AU - Vestergaard, Christian

N1 - Publisher Copyright:© 2024 The Authors. JEADV Clinical Practice published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

PY - 2024

Y1 - 2024

N2 - Background: Patients with atopic dermatitis (AD) are mostly managed by general practitioners (GPs) and practicing dermatologists (PDs) in Denmark. In cases of severe and refractory AD, the primary physician can refer the patient to a specialised dermatology department. Objectives: Aim of the study was to investigate treatment at the time of referral to a specialised dermatology department and the cause stated by the GP in a Danish cohort of AD patients referred to the Department of Dermatology, Aarhus University Hospital from 2019 to 2021. Methods: One hundred and thirty cases were randomly selected via diagnosis codes for AD. Information regarding the cause for referral and treatment given at time of referral was obtained from medical records. 18 cases were excluded due to missing referral in the patients' medical records, other diagnosis than AD or treatment initiation before 2019. The final cohort consisted of 112 cases. Differences between patients referred from GP and PD were analysed with Fisher's exact test. Results: Most cases were referred by PDs (45.5%) and GPs (24.1%). GPs primarily referred due to acute flare-ups in need of treatment (40.7%), and PDs due to lacking disease control (64.7%), (p-values < 0.0018). GPs generally included more descriptive information in their referrals than PDs, however, only the difference in mentioning sleep disturbance was significant (p-value = 0.0144). Topical corticosteroids were the preferred treatments before referral regardless of the referring doctor, with no statistical differences. Topical calcineurin inhibitors were significantly more used among PD-referred patients compared to GP-referred patients (p-value = 0.0018). Systemic therapy was initiated in 45 patients (40.2%) at the tertiary hospital with no differences between referral from either GPs or PDs. Conclusions: The study identified few differences in the referral pattern of AD to a tertiary treatment center from GPs and PDs. No major deviations from Danish guidelines were found.

AB - Background: Patients with atopic dermatitis (AD) are mostly managed by general practitioners (GPs) and practicing dermatologists (PDs) in Denmark. In cases of severe and refractory AD, the primary physician can refer the patient to a specialised dermatology department. Objectives: Aim of the study was to investigate treatment at the time of referral to a specialised dermatology department and the cause stated by the GP in a Danish cohort of AD patients referred to the Department of Dermatology, Aarhus University Hospital from 2019 to 2021. Methods: One hundred and thirty cases were randomly selected via diagnosis codes for AD. Information regarding the cause for referral and treatment given at time of referral was obtained from medical records. 18 cases were excluded due to missing referral in the patients' medical records, other diagnosis than AD or treatment initiation before 2019. The final cohort consisted of 112 cases. Differences between patients referred from GP and PD were analysed with Fisher's exact test. Results: Most cases were referred by PDs (45.5%) and GPs (24.1%). GPs primarily referred due to acute flare-ups in need of treatment (40.7%), and PDs due to lacking disease control (64.7%), (p-values < 0.0018). GPs generally included more descriptive information in their referrals than PDs, however, only the difference in mentioning sleep disturbance was significant (p-value = 0.0144). Topical corticosteroids were the preferred treatments before referral regardless of the referring doctor, with no statistical differences. Topical calcineurin inhibitors were significantly more used among PD-referred patients compared to GP-referred patients (p-value = 0.0018). Systemic therapy was initiated in 45 patients (40.2%) at the tertiary hospital with no differences between referral from either GPs or PDs. Conclusions: The study identified few differences in the referral pattern of AD to a tertiary treatment center from GPs and PDs. No major deviations from Danish guidelines were found.

KW - atopic dermatitis

KW - general practice

KW - practicing dermatologist

KW - referral pattern

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U2 - 10.1002/jvc2.374

DO - 10.1002/jvc2.374

M3 - Journal article

AN - SCOPUS:85186437394

SN - 2768-6566

JO - JEADV Clinical Practice

JF - JEADV Clinical Practice

ER -

Danielsen AK, Frølunde AS, Heilskov S, Deleuran M, Laust Thomsen J, Vestergaard C. Treatment and referral patterns of patients with atopic dermatitis from the Danish primary care system to the tertiary care system. JEADV Clinical Practice. 2024. doi: 10.1002/jvc2.374