A rash on the skin which is itchy, red, swollen and cracked is known as atopic dermatitis (AD) or atopic eczema. This type of rash starts in early childhood, may change in severity throughout the years. In some patients, it may be triggered by an allergic reaction to certain protein contained in cows' milk known as cows' milk allergy (CMA). Anytime an allergic reaction occurs, the body releases certain natural chemicals in response. Natural chemicals in the body that fight infection usually respond rapidly and can potentially involve a severe, life-threatening condition.
To understand the evolution of AD and CMA in children and its burden on the health care system, we propose to examine a group of patients with minimum age of 5 AND who have both a diagnosis of AD and CMA, who are prescribed CMA medication. We would like to determine how these patients utilise healthcare resources as they grow older. Thus, we could formulate the pathway these patients navigate in the UK health system.
The primary objective of this study is to describe the pathway of AD/CMA patients in terms of interaction with and burden upon the healthcare system. This burden will be measured by interactions with both Primary and Secondary care.
Patients with an age of 5 years and over from a HES-linked practice with any recorded read code diagnosis of AD AND any product used to treat CMA from the list included. The study period will be from 5 years, from April 2012 to March 2017. The index date for inclusion of a patient shall be the first diagnosis of AD and prescription of a CMA product within the study period. Outcomes would be tracked for all available time within the study period after the index date and annualised for comparison.
With the outcomes measured, the pathway of AD/CMA patients may be described, with stipulations as to the burden of care for both primary and secondary care.
Incidence of atopic dermatitis (AD) in both primary and secondary care settings, and in each setting and geographic area in the database
- Inpatient admissions for AD (volume, cost, elective vs non-elective, seasonality, admission method, and discharge destination)
- Average inpatient length of stay
- 30-day readmission rate following an admission for AD
- Inpatient healthcare costs as stipulated in associated HRG-4+ codes of the dominant episode
- Outpatient appointments related to AD (volume, face-to-face vs tele consults, attended vs not attended, costs)
- Outpatient appointments related to AD in the Dermatology or Paediatric specialties/clinics
- Outpatient appointment cost and activity, including procedures performed
- Outpatient procedures performed on patients consulting with AD
- Outpatient prescriptions related to AD (total, number of products prescribed, and cost if available)
Hassan Chaudhury - Chief Investigator - Health iQ Ltd ( UK ) t/a CorEvitas
Adrian Paul J. Rabe - Corresponding Applicant - Health iQ Ltd ( UK ) t/a CorEvitas
Austen El-Osta - Collaborator - Imperial College London
HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data