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

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
• topical corticosteroids
• primary care
• dermatology

Disclosure statement

Dr. Armstrong has served as an investigator and/or consultant to Abbvie, BMS, Dermavant, Dermira, Eli Lilly, Janssen, Leo Pharma, Kyowa Hakko Kirin, Modernizing Medicine, Novartis, Ortho Dermatologics, Regeneron, Sanofi, Sun Pharma, and UCB.

Data availability statement

Datasets related to this article can be found at ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Datasets/NAMCS, an open source online data repository hosted at the National Center for Health Statistics of the Centers for Disease Control and Prevention (National Information Technical Services, 2016).