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

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.

Rosacea videos on social media: A comparison of accuracy, quality, and viewer engagement.

BACKGROUND: Little is known regarding the accuracy, quality, and viewer engagement of video-based online education. OBJECTIVE: To assess the accuracy, quality, viewer engagement, and viewer experience of rosacea videos on social media. METHODS: Reviewers searched "rosacea" and examined videos on YouTube in September 2018. Videos were categorized by source: 1) Healthcare sources: university/professional organizations, industry, and individuals that were healthcare professionals, and 2) Non-healthcare sources: lay media and individuals that were not healthcare professionals. Video accuracy was measured using the Dy et al. Accuracy Scale (DAS) and Accuracy in Digital-health Instrument (ANDI). Video quality was measured using the Global Quality Scale (GQS). Viewer engagement was measured by the engagement ratio (total likes+dislikes+comments/total views). RESULTS: Of the videos analyzed, 71.7% of videos were from non-healthcare sources. Videos produced by healthcare sources (28.3%) were significantly more accurate than those produced by non-healthcare sources, as measured by ANDI (3.57±0.83 versus 2.54±1.07, P=0.001). Videos created by non-healthcare sources received significantly greater engagement than those by healthcare professionals (viewer engagement ratio 0.031±0.044 versus 0.014±0.013, P=0.0159). CONCLUSION: Rosacea videos on social medi produced by non-healthcare sources were less accurate and of lower quality but received greater viewer engagement than those produced by healthcare sources.

Association between atopic dermatitis and conjunctivitis in adults: a population-based study in the United States.

BACKGROUND: The association between atopic dermatitis (AD) and conjunctivitis in adults has not been well established. METHODS: We conducted a cross-sectional study of the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2002 to 2015 in order to evaluate the association between AD and conjunctivitis in U.S. adults. We performed multivariable logistic regression analyses adjusting for sociodemographic factors. RESULTS: An estimated total [95% CI] of 8,581,098 [7,592,037-9,570,160] weighted AD visits and 12,853,199,920 [12,808,269,186-12,898,131,033] weighted non-AD visits were utilized for our analyses. When compared to adults without AD, adults with AD had a fourfold higher risk of conjunctivitis (OR = 4.38; 95% CI, 1.39-13.79; p = .012) and specifically, an eight-fold higher risk of allergic conjunctivitis (OR = 8.03; 95% CI, 1.76-36.58; p = .007). Among adults with AD, 67.6% of their visits for conjunctivitis were for allergic conjunctivitis. Among adults without AD, 35.4% of their visits for conjunctivitis were for allergic conjunctivitis. CONCLUSIONS: Results of this study suggest that adults with AD have a significantly higher risk of conjunctivitis and specifically, allergic conjunctivitis when compared to those without AD. It is important for dermatology providers to be aware of this association and learn to recognize and potentially manage conjunctivitis in AD patients.