아토피피부염 치료 실태에 관한 다기관 설문조사
Multicenter questionnaires on the current management of atopic dermatitis in Korea
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초록
Purpose: The effective management of atopic dermatitis (AD) adjusted to individual clinical courses and demands can be challenging to both patients and physicians. Understanding of actual situations, experienced and perceived by patients with AD and their caregivers, is essential to improve clinical outcomes and satisfaction in real practice. Methods: This multicenter survey was conducted in patients with AD or their caregivers from 9 centers with questionnaires on diagnosis and management of AD. Results: A total of 324 patients and caregivers participated in the study. Most of the AD cases were initially diagnosed by physicians (80.6%), followed by self-diagnosis. Patients and caregivers thought that allergic substances, such as house dust mites, food, and pollutants, are responsible for AD development; moisturization, environmental control, and improvement of the body constitution are important for AD management. Allergy tests were performed in 194 patients (59.9%), but allergen avoidance strategy was instructed in only 81 subjects (41.8%). Major topical medications were steroids (81.8%) and topical immunomodulators (34.3%), while systemic medications were steroids (42.6%), antihistamines (36.4%), and cyclosporins (2.8%). One hundred eighty-one subjects (55.9%) had received complementary alternative medicine, including Oriental medicine. Many subjects desired to receive individualized management, use of specialized institutions for AD as well as evidence-based, effective, sustainable treatment. Conclusion: Our findings suggest that there may still be an unmet need for patients with AD in real practice. Personalized, evidence-based, and multidisciplinary approaches, including patient education, should be implemented for good outcomes.
Abstract
Purpose: The effective management of atopic dermatitis (AD) adjusted to individual clinical courses and demands can be challenging to both patients and physicians. Understanding of actual situations, experienced and perceived by patients with AD and their caregivers, is essential to improve clinical outcomes and satisfaction in real practice. Methods: This multicenter survey was conducted in patients with AD or their caregivers from 9 centers with questionnaires on diagnosis and management of AD. Results: A total of 324 patients and caregivers participated in the study. Most of the AD cases were initially diagnosed by physicians (80.6%), followed by self-diagnosis. Patients and caregivers thought that allergic substances, such as house dust mites, food, and pollutants, are responsible for AD development; moisturization, environmental control, and improvement of the body constitution are important for AD management. Allergy tests were performed in 194 patients (59.9%), but allergen avoidance strategy was instructed in only 81 subjects (41.8%). Major topical medications were steroids (81.8%) and topical immunomodulators (34.3%), while systemic medications were steroids (42.6%), antihistamines (36.4%), and cyclosporins (2.8%). One hundred eighty-one subjects (55.9%) had received complementary alternative medicine, including Oriental medicine. Many subjects desired to receive individualized management, use of specialized institutions for AD as well as evidence-based, effective, sustainable treatment. Conclusion: Our findings suggest that there may still be an unmet need for patients with AD in real practice. Personalized, evidence-based, and multidisciplinary approaches, including patient education, should be implemented for good outcomes.
참고문헌 (14)
- Johansson SG, "A revised nomenclature for allergy. An EAACI position statement from the EAACI nomenclature task force", Allergy, 56, pp.813~824 (2001)
- Hanifin JM, "A population-based survey of eczema prevalence in the United States", Dermatitis, 18, pp.82~91 (2007)
- Schneider L, "Atopic dermatitis: a practice parameter update 2012", J Allergy Clin Immunol, 131, pp.295~299 (2013)
- 박준수, "난치성 아토피피부염 Work Group 보고서: 난치성 아토피피부염의 치료에 관한 전문가 의견서", 천식 및 알레르기, 30(4), pp.255~270 (2010), 대한천식알레르기학회
- Proudfoot LE, "The European TREatment of severe Atopic eczema in children Taskforce (TREAT) survey", Br J Dermatol, 169, pp.901~909 (2013)
- 김효빈, "아토피피부염의 치료 및 관리 실태", 천식 및 알레르기, 32(1), pp.16~20 (2012), 대한천식알레르기학회
- 박양, "한국에서 아토피피부염 진단과 치료의 임상적 실태 조사", Allergy Asthma & Respiratory Diseases, 1(3), pp.257~265 (2013), 대한 소아알레르기 호흡기학회
- Barbarot S, "Therapeutic patient education in children with atopic dermatitis: position paper on objectives and recommendations", Pediatr Dermatol, 30, pp.199~206 (2013)
- Rubel D, "Consensus guidelines for the management of atopic dermatitis: an Asia-Pacific perspective", J Dermatol, 40, pp.160~171 (2013)
- 김정은, "Disease Awareness and Management Behavior of Patients with Atopic Dermatitis: A Questionnaire Survey of 313 Patients", Annals of Dermatology, 27(1), pp.40~47 (2015), 대한피부과학회
- 조성은, "아토피피부염 통합치료 프로그램에서의 심리적 개입의 실제", 천식 및 알레르기, 30(2), pp.100~109 (2010), 대한천식알레르기학회
- Segal AO, "CSACI position statement: safety of topical calcineurin inhibitors in the management of atopic dermatitis in children and adults", Allergy Asthma Clin Immunol, 9, pp.24~ (2013)
- Saavedra JM, "Patterns of clinical management of atopic dermatitis in infants and toddlers: a survey of three physician specialties in the United States", J Pediatr, 163, pp.1747~1753 (2013)
- Mohan GC, "Comparison of dermatology and allergy guidelines for atopic dermatitis management", JAMA Dermatol, 151, pp.1009~1013 (2015)
