Who sees you matters: a population study examining topical corticosteroid prescribing patterns between primary care providers and dermatologists for atopic dermatitis

J Dermatolog Treat. 2022 May;33(3):1507-1510. doi: 10.1080/09546634.2020.1836311. Epub 2020 Oct 22.

Abstract

Background: Many patients with atopic dermatitis seek care from both primary care physicians and dermatologists. However, little is known regarding topical corticosteroid prescribing patterns among these specialties.

Objective: We sought to determine if differences exist in topical corticosteroid prescribing patterns among dermatologists, family medicine physicians, and internal medicine physicians.

Methods: We conducted a population-based, cross-sectional analysis using data from the U.S. National Ambulatory Medical Care Survey from 2006 to 2016.

Results: Compared to dermatologists, internal medicine physicians were 22 times less likely to prescribe a topical corticosteroid for atopic dermatitis (52.2% versus 5.1%, p = .001; adjusted OR 0.045, 95%CI 0.007-0.277). There was not a statistically significant difference in the rate of topical corticosteroid prescriptions for atopic dermatitis between family medicine physicians and dermatologists (39.1% vs. 52.2%, p = .27; adjusted OR 0.468, 95%CI 0.174-1.257). Family medicine physicians had a higher rate of prescribing topical corticosteroids for atopic dermatitis than internal medicine physicians (39.1% vs. 5.1%, p = .002).

Limitations: Severity of atopic dermatitis was not assessed.

Conclusions: Atopic dermatitis patients seen by internal medicine physicians are much less likely to receive topical corticosteroid prescriptions as compared to those seen by dermatologists.

Keywords: Atopic dermatitis; dermatology; primary care; topical corticosteroids.

MeSH terms

  • Cross-Sectional Studies
  • Dermatitis, Atopic* / drug therapy
  • Dermatitis, Atopic* / epidemiology
  • Dermatologic Agents* / therapeutic use
  • Dermatologists
  • Glucocorticoids / therapeutic use
  • Humans
  • Primary Health Care

Substances

  • Dermatologic Agents
  • Glucocorticoids