Adherence to Guideline-Oriented Preventive Measures in Patients with Atopic Dermatitis in Germany

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that is often associated with comorbidities and quality of life losses. The implementation of evidence-based preventive measures strengthens patient participation and offers the potential to improve quality of care for AD. Objectives: To assess adherence to guideline-oriented preventive measures in adult patients with AD in dermatological routine care in Germany. Methods: The self-responsible application of preventive measures, clinical features, pruritus, disease severity, and duration of disease as well as skin disease-related quality of life were assessed in two independent cross-sectional studies in 2010 and 2017-2019. Results: Between 2017 and 2019, 706 patients (55.8% female, mean age 41 years) were recruited in a comparable way to the survey in 2010 with 1,678 patients (60.5% female, mean age 38 years). Regular skin care was applied by 99.5% (2010: 94.9%), 90.9% avoided skin irritants (2010: 84.6%), and 80.2% (2010: 61.6%) did not smoke at home. Relaxation techniques were applied by 44.4% (2010: 29.9%). Advice on self-help measures was taken by 36.4% (2010: 27.1%) and 29.2% (2010: 15.4%) attended AD patient education courses. All six preventive measures categorized as obligatory were performed by 13.9% of the patients (2010: 6.7%). Predictors for the number of obligatory preventive measures applied were a high level of education, a longer disease duration, and a lower quality of life. Conclusions: Although the self-reported use of evidence-based preventive measures in the 2017-2019 study appears to be more frequent than in 2010, important measures are still insufficiently established. Hence, more implementation, including education, is needed to increase the use of guideline-oriented preventive measures.