Determinants of treatment goals and satisfaction of patients with atopic eczema

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Abstract
Despite the high prevalence, morbidity, and economic burden of atopic eczema,data on patients' treatment goals and treatment satisfaction are missing. A cross-sectional study was performed with standardized survey of all adult patients treated between 01/2004 and 03/2006 in the atopic eczema outpatient unit of the Department of Dermatology, TU Dresden, Germany. Assessed were disease-specific characteristics (age at onset, treatment, disease severity, quality of life impact), and aspects of health services research (treatment goals, patients' self-treatment competence, treatment satisfaction). Treatment satisfaction was assessed on a 100 mm visual analog scale with 0 reflecting "very dissatisfied", and 100 "highly satisfied". Based on an a priori model we analyzed the impact of sociodemographic and disease-specific factors on treatment satisfaction (primary endpoint) using multivariate regression modeling. Of the 267 patients asked to participate, 226 (85 %) agreed. Mean treatment satisfaction was 59.6 (+/- 30.8). Age and sex were not significantly associated with treatment satisfaction. Professional competence of the treating physician was the most important determinant of treatment satisfaction, followed by physician's sensitivity, disease severity, education about the condition, and patient's competence to adjust treatment to disease activity. Reduction of itching and burning, as well as complete clearing of all skin changes, were the most important treatment goals. For adult patients with atopic eczema the impression of professional competence of the treating physician has highest priority. Disease severity only explains 20 % of the total variance of treatment satisfaction. Comprehensive information about the condition and reinforcement of patients' treatment competence should be better integrated in clinical practice.