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Care for children with atopic dermatitis in the Netherlands during the COVID-19 pandemic: Lessons from the first wave
Aviël Ragamin1,2, Linde E M de Wijs2, Dirk-Jan Hijnen2
1Department of Dermatology-Center of Pediatric Dermatology, Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital-Kinderhaven, Rotterdam, The Netherlands.
Insights
The COVID-19 pandemic increased remote consultations for pediatric atopic dermatitis (AD) care, with high overall patient satisfaction despite some disease worsening. Face-to-face visits led to greater satisfaction than telehealth.
Area of Science:
- Pediatric Dermatology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic significantly disrupted healthcare services globally.
- Children with atopic dermatitis (AD) require consistent care, which was challenged during the pandemic.
- Tertiary outpatient clinics experienced shifts in service delivery models.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic's first wave on pediatric atopic dermatitis (AD) care.
- To compare consultation numbers and types before and during the pandemic.
- To assess patient and caregiver satisfaction with care during this period.
Main Methods:
- Retrospective review of outpatient records for children with moderate to severe AD.
- Comparison of consultation data from March-July 2020 (pandemic wave) with the same periods in 2019 and 2018.
- A questionnaire-based study on clinical/psychological symptoms and care satisfaction.
Main Results:
- Total consultations increased during the first COVID-19 wave (913 in 2020 vs. 698 in 2019 and 591 in 2018).
- The proportion of remote consultations surged to 56.2% in 2020, compared to ~13% in prior years.
- Overall satisfaction was high (8.6/10), though face-to-face consultations yielded higher satisfaction than remote ones (p=0.026).
- Only 9.7% of caretakers reported AD worsening.
Conclusions:
- The COVID-19 pandemic significantly altered care delivery for pediatric atopic dermatitis, notably increasing telehealth usage.
- Despite changes, overall patient satisfaction remained high, indicating adaptability of care models.
- Remote consultations proved a viable tool, though in-person visits were preferred for higher satisfaction.
Abstract:
The first wave of the coronavirus disease 2019 (COVID-19) pandemic had an enormous impact on health-care services, including on care provision for children with atopic dermatitis (AD). We investigated the impact of COVID-19 on the care for children with moderate to severe AD at our tertiary outpatient clinic and examined satisfaction with care. We reviewed outpatient records, comparing total number and types of consultations during the first COVID-19 wave (March until July 2020) with the corresponding months of 2019 and 2018. In addition, we conducted a questionnaire-based study investigating the impact of COVID-19 on clinical and psychological symptoms, and satisfaction with care. A total number of 913 consultations (466 individual children) were conducted during the first COVID-19 wave in 2020, while 698 (391 individual children) and 591 consultations (356 individual children) were conducted in 2019 and 2018. The proportion of remote consultations was higher (56.2%) compared to 14.0% in 2019 and 12.7% in 2018. Worsening of AD was reported by 9.7% of caretakers. Overall satisfaction with provided care was high (8.6; interquartile range [IQR] = 7.3-10.0). Caretakers receiving face-to-face consultation were significantly (p = 0.026) more satisfied (9.0; IQR = 8.0-10.0) than caretakers receiving remote consultation (7.9; IQR = 7.0-9.5). The COVID-19 pandemic had an unprecedented impact on care provision for children with AD, particularly on the number of remote consultations. Overall satisfaction with care was high. The impact of COVID-19 on disease severity remained limited. Remote consultations seem to be a useful tool that can be put into practice during the COVID-19 pandemic.
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