Epidemiology and management of atopic dermatitis in England: an observational cohort study protocol
Introduction Atopic dermatitis (AD) is one of the most common inflammatory skin conditions in both children and adults. Despite this, contemporary descriptions of the incidence, prevalence and current management of the condition in the UK are lacking.Methods and analysis We will perform a series of...
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| Format: | Article |
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e037518.full |
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| author | Simon de Lusignan Carsten Flohr John Dennis Helen Alexander Conor Broderick Andrew McGovern Claire Feeney |
| author_facet | Simon de Lusignan Carsten Flohr John Dennis Helen Alexander Conor Broderick Andrew McGovern Claire Feeney |
| author_sort | Simon de Lusignan |
| collection | DOAJ |
| description | Introduction Atopic dermatitis (AD) is one of the most common inflammatory skin conditions in both children and adults. Despite this, contemporary descriptions of the incidence, prevalence and current management of the condition in the UK are lacking.Methods and analysis We will perform a series of retrospective studies using a large population-based cohort derived from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network database to explore two key research themes: AD epidemiology and AD management.In the epidemiology theme, we will describe the incidence and prevalence of AD in children and adults in England from 2009 to 2018 inclusive. We will stratify findings by age, national Index of Multiple Deprivation (IMD), ethnicity, urban-rural environment and geographic location; and explore independent associations of these features with AD in multivariable models.In the management theme, we will explore healthcare utilisation and treatment in people with AD. Regarding healthcare utilisation, we will evaluate rates of AD-associated primary care visits and specialist dermatology referrals in people with AD. Rates will be stratified by age, gender, socioeconomic IMD quintile and ethnicity. We will describe contemporary treatment by estimating prescribing rates across medication classes used in AD (emollients, topical corticosteroids by potency, topical calcineurin inhibitors, topical antimicrobials, antihistamines, oral corticosteroids and systemic immunomodulatory therapies) overall, and by age and sociodemographic groupings. We will also examine trends in prescribing over the study period. In people first diagnosed with AD during the study period, we will describe differences in treatment escalation by sociodemographic factors using time-to-event analysis.Ethics and dissemination The Health Research Authority decision tool classed this a study of ‘usual practice’, ethics approval was not required. Study approval was granted by the RCGP RSC Study Approval Committee. Results will be disseminated through peer-reviewed publications.Trial registration number NCT03823794. |
| format | Article |
| id | doaj-art-1fb3e71a378a45b6a5c9671055cf0c00 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-1fb3e71a378a45b6a5c9671055cf0c002025-01-08T18:40:09ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-037518Epidemiology and management of atopic dermatitis in England: an observational cohort study protocolSimon de Lusignan0Carsten Flohr1John Dennis2Helen Alexander3Conor Broderick4Andrew McGovern5Claire Feeney6Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UKUnit for Population-Based Dermatology Research, St John`s Institute of Dermatology, Guy`s and St Thomas` NHS Foundation Trust and King`s College London, London, UKPhD studentUnit for Population-Based Dermatology Research, St John`s Institute of Dermatology, Guy`s and St Thomas` NHS Foundation Trust and King`s College London, London, UKUnit for Population-Based Dermatology Research, St John`s Institute of Dermatology, Guy`s and St Thomas` NHS Foundation Trust and King`s College London, London, UKclinical researcherPfizer, Surrey, UKIntroduction Atopic dermatitis (AD) is one of the most common inflammatory skin conditions in both children and adults. Despite this, contemporary descriptions of the incidence, prevalence and current management of the condition in the UK are lacking.Methods and analysis We will perform a series of retrospective studies using a large population-based cohort derived from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network database to explore two key research themes: AD epidemiology and AD management.In the epidemiology theme, we will describe the incidence and prevalence of AD in children and adults in England from 2009 to 2018 inclusive. We will stratify findings by age, national Index of Multiple Deprivation (IMD), ethnicity, urban-rural environment and geographic location; and explore independent associations of these features with AD in multivariable models.In the management theme, we will explore healthcare utilisation and treatment in people with AD. Regarding healthcare utilisation, we will evaluate rates of AD-associated primary care visits and specialist dermatology referrals in people with AD. Rates will be stratified by age, gender, socioeconomic IMD quintile and ethnicity. We will describe contemporary treatment by estimating prescribing rates across medication classes used in AD (emollients, topical corticosteroids by potency, topical calcineurin inhibitors, topical antimicrobials, antihistamines, oral corticosteroids and systemic immunomodulatory therapies) overall, and by age and sociodemographic groupings. We will also examine trends in prescribing over the study period. In people first diagnosed with AD during the study period, we will describe differences in treatment escalation by sociodemographic factors using time-to-event analysis.Ethics and dissemination The Health Research Authority decision tool classed this a study of ‘usual practice’, ethics approval was not required. Study approval was granted by the RCGP RSC Study Approval Committee. Results will be disseminated through peer-reviewed publications.Trial registration number NCT03823794.https://bmjopen.bmj.com/content/10/9/e037518.full |
| spellingShingle | Simon de Lusignan Carsten Flohr John Dennis Helen Alexander Conor Broderick Andrew McGovern Claire Feeney Epidemiology and management of atopic dermatitis in England: an observational cohort study protocol BMJ Open |
| title | Epidemiology and management of atopic dermatitis in England: an observational cohort study protocol |
| title_full | Epidemiology and management of atopic dermatitis in England: an observational cohort study protocol |
| title_fullStr | Epidemiology and management of atopic dermatitis in England: an observational cohort study protocol |
| title_full_unstemmed | Epidemiology and management of atopic dermatitis in England: an observational cohort study protocol |
| title_short | Epidemiology and management of atopic dermatitis in England: an observational cohort study protocol |
| title_sort | epidemiology and management of atopic dermatitis in england an observational cohort study protocol |
| url | https://bmjopen.bmj.com/content/10/9/e037518.full |
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