NOTE_Patient_Data_to_be_updated:Expected_study_completion_July

OBJECTIVES: Sparse Irish healthcare resource use data is available. This study aims to describe secondary care resource use for patients with moderate-to-severe atopic dermatitis (AD) at Ireland’s largest paediatric hospital, Children’s Health Ireland at Crumlin (CHI).

METHODS: A retrospective non-interventional study, utilising data collected from CHI records of patients aged 6 to 17 with clinically confirmed, inadequately controlled AD despite current treatments. Patients were <18 years at their most recent consultation and were required to have CHI records from January 1^st 2014 with minimum 12 months follow-up whilst aged 6-17. Patient demographics, clinical characteristics, consultations, hospitalisations and treatment history are described.

RESULTS: Thirty-one patients were evaluated (61.3% male; mean age 14.8 [SD=2.9] years; disease severity at first referral: severe 74.2%; moderate 25.8%). Most common comorbidities were food allergies (61.3%), asthma (58.1%) and allergic rhinitis (51.6.4%). Mean number of concomitant conditions per patient was 2.7 [SD=1.5]). There were 473 secondary care consultations during the observation period (mean per patient: 15.3 (SD=6.3); mean per patient-year of observation period: 3.2 [SD=1.3]); the majority of which were registrar (83.9%) and/or consultant dermatologist (74.2%) appointments. The most common reasons for consultations were clinical/treatment review (58.8%), routine appointment (47.8%), and/or flare (5.9%). A mean of 8.7 [SD=4.1] flares per patient were recorded (2.0 [SD=1.1] per patient-year). Eight patients were hospitalised for flares (mean hospitalisations per hospitalised patient: 1.5 [SD=0.5]; mean number of nights spent in hospital per hospitalised patient over observation period: 6.6 [SD=3.5]). A mean of 13.4 (SD=4.8) treatments per patient were prescribed over the observation period (3.7 [SD=2.2] per patient-year).

CONCLUSIONS: Moderate-to-severe AD in paediatric patients results in complex treatment pathways, with high secondary healthcare burden in the dermatology outpatient setting. The number of flares experienced by patients, despite complex management, suggests a lack of effective long-term therapeutic options for these patients in Ireland.