Perceived Readiness and Barriers to Self-Management in Pediatric Atopic Dermatitis Patients and Parents

Adolescents and young adults (AYA) with atopic dermatitis (AD) must transition from caregiver-led to self-managed care and eventually to adult healthcare providers. While transition readiness is well studied in other chronic conditions, it remains underexplored in AD. This study assesses transition readiness and perceived barriers to self-management among AYA with AD and parents of AYA.

A cross-sectional, online survey was conducted from June to July 2024 by the National Eczema Association among US-based AYA (ages 12-22) with AD and parents of AYA with AD. Transition readiness was evaluated using the Transition Readiness Assessment Questionnaire (TRAQ 6.0). TRAQ scores ≥ 4 indicated transition readiness. Parent-reported TRAQ scores assessed perceptions of their child's readiness. Group comparisons used t-tests and Chi-square tests.

Of 307 respondents (211 AYA, 96 parents), AYA were older (18.8 vs. 16.2 years, p < 0.001), and more likely to be female (72.0% vs. 57.3%, p < 0.001) than the children of parent respondents. Mean TRAQ scores were higher for AYA than parents (3.94 vs. 2.98, p < 0.001). After stratification, AYA scores remained higher for both adolescents (3.33 vs. 2.58, p < 0.001) and young adults (4.16 vs. 3.78, p = 0.008), with the largest discrepancy in appointment keeping. Older age, lower AD severity, and specialist care were associated with higher readiness (TRAQ ≥ 4). Most respondents rated self-management as very important (89.6%), though only 40.3% felt very/extremely confident. Top barriers included fear of treatment side effects (AYA 53%) and disease variability (parents 36%).

AYA report greater transition readiness than parents perceive. Structured transition planning involving both groups may improve alignment and confidence in AD self-management.