Collaborative Management of Atopic Dermatitis - Episode 2
Peter A. Lio, MD: Atopic dermatitis has a huge impact on not only the patient but also the caregivers, the family unit, the social unit, schools, work, and so on. It has this incredible rippling effect throughout society. We know that the impact, which is intense for both kids and adults, seems to be particularly hard on children because they often have a higher rate of sleep issues that go along with it. Because their whole family unit is involved, it really affects them at multiple angles and multiple times. When patients come into the clinic, the kid looks terrible and exhausted, but so do the parents. They have bags under their eyes, they’re miserable, they’re feeling worn down. The impact is even greater in kids. That’s not to minimize its effect in adults.
Not only is there the important issue of poor sleep in adults, but there’s the concept of absenteeism, missing work, or missing events. But there’s even presenteeism. Something that I only learned about a few years ago. This idea that you might show up—you didn’t miss work that day, but you’re not all there, you’re distracted, you’re overtired, you’re not able to concentrate and focus. This is a huge problem for many patients with chronic disease.
There is tremendous burden both psychologically and financially for our patients with atopic dermatitis. It’s amazing. A lot of the health care costs that are calculated look at the doctor visits, emergency department visits, and some of the prescription medicines. But there is an entire underbelly of financial issues that plague these patients that are simply not accounted for, and these include all the over-the-counter products that people try. Many people are desperate and try many things, including a lot of junk. Perhaps they see it on the Internet late at night when they’re searching for an answer; they try these things. It also fails to include the time put in. There’s an enormous amount of time that it takes to put on a regimen, either for yourself as a patient or if you’re taking care of child. Putting on the special cleansers, the moisturizers, and the medicines take time and energy.
As you can imagine, this has a massive impact on the psychological aspects for not only the patient but their family unit and beyond. When you meet a patient who’s really been suffering, you can feel it in that moment when you look into their eyes.
There is tremendous financial and psychological burden to atopic dermatitis. It goes beyond the patient themselves. It applies to the caregivers, the family unit, and even beyond. One issue is that when you look at papers that try to quantify the financial impact, there are lots of limitations. In particular, they usually look at doctor visits, prescription medicine, and time away from work or school.
What they often fail to capture effectively is that underbelly of financial burden that patients often have. That includes all the over-the-counter products that are recommended that are generally not accounted for or covered by insurance, including some things that they seek out in desperation and over pay for online. It also fails to include the time factor. It takes a tremendous amount of time to put on all the medicines, moisturizers, and special types of cleansers. These different parts of their routine are unaccounted for by many. As you might imagine, this has a huge impact on the psychological burden for patients, caregivers, and families with atopic dermatitis.
That’s really hard to quantify sometimes, but you can often feel it. The moment you meet them and look them in the eye, you realize what a terrible impact the disease has had on everybody.
Transcript Edited for Clarity