Diagnosis, assessment, and treatment of childhood eczema in primary care: cross-sectional study
Background: The majority of children with eczema in the UK are looked after in primary care yet we know little about their care in this setting. Aim: To compare the diagnosis, assessment, and treatment of eczema in primary care with published diagnostic criteria and management guidelines. Design &am...
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| Format: | Article |
| Language: | English |
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Royal College of General Practitioners
2017-05-01
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| Series: | BJGP Open |
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| Online Access: | https://bjgpopen.org/content/1/2/bjgpopen17X100821 |
| _version_ | 1818268431861940224 |
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| author | Laureen Jacquet Daisy M Gaunt Kirsty Garfield Matthew J Ridd |
| author_facet | Laureen Jacquet Daisy M Gaunt Kirsty Garfield Matthew J Ridd |
| author_sort | Laureen Jacquet |
| collection | DOAJ |
| description | Background: The majority of children with eczema in the UK are looked after in primary care yet we know little about their care in this setting. Aim: To compare the diagnosis, assessment, and treatment of eczema in primary care with published diagnostic criteria and management guidelines. Design & setting: Cross-sectional study using data from a randomised controlled feasibility study. General practices, UK. Method: Baseline data from children aged 1 month to 5 years recruited ‘in-consultation’ for the Choice of Moisturiser in Eczema Treatment (COMET) feasibility study was used. These included clinician diagnosis and global severity assessment; the parent-completed Patient Orientated Eczema Measure (POEM); a questionnaire about eczema treatments, including use of topical corticosteroid (TCS); and, the Eczema Area Severity Index (EASI) carried out by trained researchers. Descriptive analyses were undertaken to compare diagnoses with UK diagnostic criteria, severity assessments, and treatment with the National Institute for Health and Care Excellent (NICE) guidance. Results: Data were available for 90 participants. Only 46% of participants labelled as having eczema met the UK diagnostic criteria. Agreement between the global severity assessment by a healthcare practitioner with the EASI and POEM measures of eczema severity were 44% and 48% respectively. Emollients and TCSs were underused with 44% of participants not using any emollient and 46% using one or more TCSs. The ‘match’ between eczema severity and TCSs potency was poor. Conclusion: Discrepancies were found between the diagnosis, assessment, and treatment of children with eczema in primary care, and UK diagnostic criteria and guidelines. Further investigation to explore the reasons for this discordance, and whether it matters, is needed. |
| first_indexed | 2024-12-12T20:38:23Z |
| format | Article |
| id | doaj.art-78ae068106624928a727d12ca1b9531e |
| institution | Directory Open Access Journal |
| issn | 2398-3795 |
| language | English |
| last_indexed | 2024-12-12T20:38:23Z |
| publishDate | 2017-05-01 |
| publisher | Royal College of General Practitioners |
| record_format | Article |
| series | BJGP Open |
| spelling | doaj.art-78ae068106624928a727d12ca1b9531e2022-12-22T00:12:49ZengRoyal College of General PractitionersBJGP Open2398-37952017-05-011210.3399/bjgpopen17X100821Diagnosis, assessment, and treatment of childhood eczema in primary care: cross-sectional studyLaureen Jacquet0Daisy M Gaunt1Kirsty Garfield2Matthew J Ridd3School of Social and Community Medicine, University of Bristol, Bristol, UKSchool of Social and Community Medicine, University of Bristol, Bristol, UKSchool of Social and Community Medicine, University of Bristol, Bristol, UKSchool of Social and Community Medicine, University of Bristol, Bristol, UKBackground: The majority of children with eczema in the UK are looked after in primary care yet we know little about their care in this setting. Aim: To compare the diagnosis, assessment, and treatment of eczema in primary care with published diagnostic criteria and management guidelines. Design & setting: Cross-sectional study using data from a randomised controlled feasibility study. General practices, UK. Method: Baseline data from children aged 1 month to 5 years recruited ‘in-consultation’ for the Choice of Moisturiser in Eczema Treatment (COMET) feasibility study was used. These included clinician diagnosis and global severity assessment; the parent-completed Patient Orientated Eczema Measure (POEM); a questionnaire about eczema treatments, including use of topical corticosteroid (TCS); and, the Eczema Area Severity Index (EASI) carried out by trained researchers. Descriptive analyses were undertaken to compare diagnoses with UK diagnostic criteria, severity assessments, and treatment with the National Institute for Health and Care Excellent (NICE) guidance. Results: Data were available for 90 participants. Only 46% of participants labelled as having eczema met the UK diagnostic criteria. Agreement between the global severity assessment by a healthcare practitioner with the EASI and POEM measures of eczema severity were 44% and 48% respectively. Emollients and TCSs were underused with 44% of participants not using any emollient and 46% using one or more TCSs. The ‘match’ between eczema severity and TCSs potency was poor. Conclusion: Discrepancies were found between the diagnosis, assessment, and treatment of children with eczema in primary care, and UK diagnostic criteria and guidelines. Further investigation to explore the reasons for this discordance, and whether it matters, is needed.https://bjgpopen.org/content/1/2/bjgpopen17X100821atopic dermatitiseczemadiagnostic criteriadisease managementtreatment |
| spellingShingle | Laureen Jacquet Daisy M Gaunt Kirsty Garfield Matthew J Ridd Diagnosis, assessment, and treatment of childhood eczema in primary care: cross-sectional study BJGP Open atopic dermatitis eczema diagnostic criteria disease management treatment |
| title | Diagnosis, assessment, and treatment of childhood eczema in primary care: cross-sectional study |
| title_full | Diagnosis, assessment, and treatment of childhood eczema in primary care: cross-sectional study |
| title_fullStr | Diagnosis, assessment, and treatment of childhood eczema in primary care: cross-sectional study |
| title_full_unstemmed | Diagnosis, assessment, and treatment of childhood eczema in primary care: cross-sectional study |
| title_short | Diagnosis, assessment, and treatment of childhood eczema in primary care: cross-sectional study |
| title_sort | diagnosis assessment and treatment of childhood eczema in primary care cross sectional study |
| topic | atopic dermatitis eczema diagnostic criteria disease management treatment |
| url | https://bjgpopen.org/content/1/2/bjgpopen17X100821 |
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