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Healthcare Service Utilization and Medication Use in 128,239 Children with Atopic Dermatitis in Israel-A
Naama Tova Cohen1, Amit Iton-Schwartz2, Doron Comaneshter3
1Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel.
Insights
Children with atopic dermatitis (AD) use more healthcare services and are prescribed advanced treatments like immunosuppressants, biologics, and Janus kinase (JAK) inhibitors at higher rates. Systemic therapies may benefit moderate to severe pediatric AD cases.
Area of Science:
- Pediatric Dermatology
- Health Services Research
- Pharmacology
Background:
- Atopic dermatitis (AD) is a chronic inflammatory skin condition requiring ongoing management.
- Pediatric AD significantly impacts healthcare resource utilization.
- Understanding medication patterns in pediatric AD is crucial for treatment optimization.
Purpose of the Study:
- To analyze healthcare service utilization in children diagnosed with atopic dermatitis.
- To evaluate the patterns of medication use, including advanced therapies, in pediatric patients with AD.
- To compare healthcare use and treatment strategies between children with and without AD.
Main Methods:
- A cross-sectional case-control study design.
- Comparison of 128,239 children with AD against 128,239 matched controls.
- Multivariate analysis to assess differences in healthcare utilization and medication use.
Main Results:
- Children with AD exhibited significantly higher healthcare utilization across various specialist visits.
- Increased prescription rates for immunosuppressive drugs (OR 1.8), biologic drugs (OR 34.3), and Janus kinase (JAK) inhibitors (OR 17) were observed in the AD cohort.
- Despite increased utilization, only a small fraction of pediatric AD patients received these advanced systemic treatments.
Conclusions:
- Pediatric patients with atopic dermatitis demonstrate elevated healthcare service utilization.
- The study suggests a potential underutilization of systemic medications like immunosuppressants, biologics, and JAK inhibitors in moderate to severe pediatric AD.
- Consideration of systemic therapies is recommended for managing moderate to severe cases of pediatric atopic dermatitis.
Abstract:
Background: Atopic dermatitis (AD) is a chronic inflammatory disease requiring topical and systemic treatments. This study examines healthcare service utilization and medication use in children with AD in a large healthcare organization during the year 2024. Methods: A cross-sectional case-control study was conducted comparing 128,239 children with AD to 128,239 matched controls regarding healthcare utilization and medication use. Multivariate analysis assessed differences between the groups. Results: Children with AD had increased healthcare utilization compared to the control group, with higher rates of visits to pediatricians, general practitioners, and dermatologists. A total of 144 children (0.11%) with AD were treated by immunosuppressive drugs, as compared to 78 children (0.06%) in the control group (OR 1.8, 95% CI 1.4-2.4, p-value < 0.001). A total of 410 children (0.32%) were treated with biologic drugs as compared to 12 children (0.01%) in the control group (OR 34.3, 95% CI 19.3-60.9, p-value < 0.001). A total of 34 children (0.03%) were treated with Janus kinase (JAK) inhibitors as compared to 2 children (0.002%) in the control group (OR 17, 95% CI 4.1-70.8, p-value < 0.001). Conclusions: Increased utilization of healthcare services was observed in pediatric patients with AD compared to the control group. As only a small proportion of the children with AD received immunosuppressants, biologic treatments, and JAK inhibitors, we suggest that the use of systemic medications should be strongly considered in pediatric patients with moderate to severe AD.
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