For the adult patient population, 150 physicians (60 PCPs/internists, 70 dermatologists, and 20 allergists/immunologists) participated in the DSP (Table 1). The total adult patient population sampled consisted of 749 patients. After exclusion of patients who had not been on their current therapy for at least 1 month, 424 matched adult patients met analysis requirements and were included. In the adolescent patient population, 103 physicians (10 PCPs/internists, 22 pediatricians, 50 dermatologists, and 21 allergists/immunologists) provided data for 304 patients. After patients who had not been on their current therapy for at least 1 month were excluded, 151 eligible matched adolescent patients were included.

Out of the total 575 patients included in the study, 538 (93.6%; adults, n = 394; adolescents, n = 144) received topical therapy and were included in the analysis. Of these patients, 398 (adults, n = 284; adolescents, n = 114) received topical therapy only, and 140 (adults, n = 110; adolescents, n = 30) received topical plus systemic therapy (Table 2). Mean (SD) age was 38.2 (15.0) years for the adult cohort and 14.6 (1.7) years for the adolescent cohort. Patient demographics and baseline clinical characteristics were generally similar among those receiving topical therapy alone compared with topical plus systemic therapy for both the adult and adolescent cohorts (Table 3). Among adult patients, 246 (62.4%) were working full time and 34 (8.6%) were working part time at the time of the study. Approximately half of patients had at least one concomitant type II inflammatory disease (i.e., T helper type 2 allergic immune response), with allergic rhinitis (overall, 36.6%; adults, 36.5%; adolescents, 36.8%) and asthma (overall, 27.7%; adults, 28.2%; adolescents, 26.4%) being the most common.

Per physician assessment, 132 patients (24.5%; adults, 22.8%; adolescents, 29.2%) had uncontrolled disease. Slightly more adults had uncontrolled disease on topical plus systemic therapy versus topical therapy alone (26.4% vs 21.5%; Fig. 2). Uncontrolled disease was also more common, and to a greater extent versus adults, among adolescents receiving topical plus systemic therapy versus topical therapy alone (50.0% vs 23.7%; Fig. 2). The overall rate of physician-reported dissatisfaction with disease control was 32.0% and was higher for the adolescent (42.4%) versus adult (28.2%) patient cohort. Physicians reported similar rates of dissatisfaction with disease control for their adult patients receiving topical plus systemic therapy versus topical therapy alone (“less than satisfied” in 30.9% vs 27.1%, respectively; Fig. 3i). Physicians of adolescent patients were generally less satisfied with disease control for patients receiving topical plus systemic therapy versus topicals alone (“less than satisfied” in 50.0% vs 40.4%, respectively). Out of 314 patients with evaluable responses regarding satisfaction with their current treatment, 78 (24.8%; adults, 24.0%; adolescents, 26.8%) reported being dissatisfied. Patients receiving topical plus systemic therapy reported being “less than satisfied” with treatment more often than those receiving topicals alone for both the adult (30.8% vs 21.1%, respectively) and adolescent cohorts (35.3% vs 25.0%; Fig. 3ii).

Physician-defined disease control. †Controlled disease was defined as improving/stable; uncontrolled disease was defined as deteriorating/changeable

Rates of i physician and ii patient satisfaction with disease control on current treatment

In the adult patient cohort, mean (SD) DLQI score was 6.5 (4.8); among adolescents, mean (SD) CDLQI score was 7.3 (5.1). Greater QoL impairment was observed for physician-defined uncontrolled versus controlled disease in both DLQI (mean [SD] score, 8.8 [4.8] vs 6.0 [4.6]; P = 0.0003) and CDLQI (mean [SD] score, 9.8 [5.5] vs 6.3 [4.6], respectively; P = 0.0015). DLQI and CDLQI scores were typically further increased among patients receiving topical plus systemic therapy versus topical therapy alone (Fig. 4).

i DLQI and ii CDLQI scores among patients on topical AD therapy with controlled vs uncontrolled disease. †AD atopic dermatitis, CDLQI Children’s Dermatology Life Quality Index, DLQI Dermatology Life Quality Index. **P < 0.01. †Controlled disease was defined as improving/stable; uncontrolled disease was defined as deteriorating/changeable

Mean (SD) POEM scores were 8.8 (6.3) and 10.4 (6.2) among adult and adolescent patients, respectively. Higher POEM scores were seen among patients with uncontrolled versus controlled disease in both the adult (mean [SD], 11.3 [6.1] vs 8.3 [6.2]; P = 0.0037) and adolescent (mean [SD], 13.9 [6.3] vs 9.0 [5.7]; P = 0.0002) patient cohorts. POEM scores among adolescents were generally higher than those in adults for all categories. Among adolescents, POEM scores were higher for patients receiving topical plus systemic therapy versus topicals alone, irrespective of disease control (Fig. 5).

POEM scores among i adult and ii adolescent patients on topical AD therapy with controlled vs uncontrolled disease. †AD atopic dermatitis, POEM Patient-Oriented Eczema Measure. *P < 0.05. †Controlled disease was defined as improving/stable; uncontrolled disease was defined as deteriorating/changeable

In the adult patient cohort, WPAI scores showed that mean (SD) percent of overall work impairment was 17.7 (18.2). WPAI values were higher among patients with uncontrolled versus controlled disease (mean [SD], 23.5 [17.2] vs 16.2 [18.2], respectively; P = 0.0488). This trend was observed for both users of topical therapy alone (mean [SD], 22.5 [19.1] vs 13.8 [18.4] for uncontrolled vs controlled disease, respectively) and topical plus systemic therapy (mean, 25.0 [15.0] vs 22.6 [16.1] for uncontrolled vs controlled disease; Fig. 6).

WPAI values for overall work impairment among adult patients on topical AD therapy with controlled vs uncontrolled disease. †AD atopic dermatitis, WPAI Work Productivity and Activity Impairment. †Controlled disease was defined as improving/stable; uncontrolled disease was defined as deteriorating/changeable