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Benefit of emollient prescriptions for children and adults with dry skin and atopic eczema

Emollients for dry skin Emollients for dry skin
Emollients for dry skin Emollients for dry skin

Using the Clinical Practice Research Datalink (CPRD), this retrospective group study aimed to assess the overall expenses incurred by the National Health Service (NHS) in the UK, encompassing healthcare usage, related to the prescription of emollients in primary care for individuals with dry skin and atopic eczema.

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Key take away

Prescribing emollients is associated with fewer primary care visits, decreased healthcare utilization, and lower costs. Additionally, prescribing emollients especially those containing colloidal oatmeal is linked to a decrease in the need for topical corticosteroids and antimicrobial medications.

Background

Using the Clinical Practice Research Datalink (CPRD), this retrospective group study aimed to assess the overall expenses incurred by the National Health Service (NHS) in the UK, encompassing healthcare usage, related to the prescription of emollients in primary care for individuals with dry skin and atopic eczema.

Method

Individuals in primary care in the UK were recognized through the CPRD. Their records for the two years after the initial diagnosis of dry skin and atopic eczema were examined. Data from people with emollient prescriptions (n = 45,218) and those without (n = 9,780) were analyzed. Multivariate regression models were employed to examine healthcare utilization and costs in two matched groups (matched for age, gender, and diagnosis).

Sub-analyses within the emollient group were executed to compare groups receiving colloidal oatmeal emollients (Aveeno-First) vs non-colloidal oatmeal emollients (Aveeno-Never), and those prescribed Aveeno initially (Aveeno-First) vs those prescribed Aveeno subsequently (Aveeno-Subsequently).

For calculating the odds of receiving prescriptions for potent/very potent topical corticosteroids (TCS) or skin-associated antimicrobials, logistic regression models were employed.

Result

The costs per patient were reported to be £125.80 in the Emollient group (n = 7,846) compared to £128.13 in the Non-Emollient group (n = 7,846). The Emollient group exhibited fewer visits per patient (2.44 vs. 2.66) and lower mean per-visit costs (£104.15 vs. £113.25) in comparison with the Non-Emollient group. Non-Emollient patients exhibited 18% higher odds of receiving TCS prescriptions and 13% higher odds of receiving antimicrobial prescriptions compared to Emollient patients.  In the Aveeno-First (n = 1,943) vs Aveeno-Never (n = 1,943) sub-assessment, costs per person were reduced in the Aveeno-First group (£133.46 vs. £141.11).

The Aveeno-Never group illustrated ≥21% higher odds of getting TCS or antimicrobial prescriptions than the Aveeno-First group. In the Aveeno-First (n = 1,357) vs Aveeno-Subsequently (n = 1,357) sub-assessment, total costs were reduced in the Aveeno-First group (£140.35 vs. £206.43). Patients in the Aveeno-Subsequently group demonstrated 91% higher odds of receiving TCS prescriptions and 75% higher odds of getting antimicrobial prescriptions when compared to the Aveeno-First group.

Conclusion

Despite limitations related to obscure illness intensity in the CRPD, prescribing emollients for dry skin and atopic eczema was linked with minimized visits to primary care, decreased medical care utilization, and diminished costs. Using emollients, specifically those containing colloidal oatmeal, was linked to reduced prescriptions for TCS and antimicrobials.

Source:

BMC Dermatology

Article:

Cost and effectiveness of prescribing emollient therapy for atopic eczema in UK primary care in children and adults: a large retrospective analysis of the Clinical Practice Research Datalink

Authors:

George Moncrieff et al.

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