Adolescents’ Perspectives on Atopic Dermatitis Treatment—Experiences, Preferences, and Beliefs

Question  What are the beliefs, experiences, and preferences of adolescents regarding their atopic dermatitis treatment?

Findings  This qualitative study including focus group interviews of 15 participants showed that adolescents were in general satisfied with their current treatment; however, they prefered a faster and more persistent treatment effect. Adolescents developed their own routine in using topical corticosteroids, emollients, and moisturizers, which often deviated from the medication regimen prescribed by their physician.

Meaning  Clinicians should pay more attention to improving the treatment of adolescents with atopic dermatitis.

Importance  For a considerable proportion of pediatric patients, atopic dermatitis symptoms persist into adolescence. Previous studies have focused mainly on (parents of) children, whereas little is known about adolescents with atopic dermatitis.

Objective  To explore the beliefs, experiences, and preferences of adolescents with atopic dermatitis toward their treatment.

Design, Setting, and Participants  We conducted a qualitative study employing focus group interviews of 15 adolescents (aged 12-18 years) who collected at least 1 prescription for topical corticosteroids in class 2 (moderately potent) or 3 (potent) in the preceding year. The study included 9 community pharmacies in 3 different regions in the Netherlands. Data were collected from November to December 2016, until data saturation was reached. Focus groups were recorded, transcribed verbatim, and data were analyzed by 2 researchers.

Main Outcomes and Measures  Adolescents’ beliefs, experiences, and preferences toward their atopic dermatitis treatment were explored during focus groups. We used a thick analysis approach to analyze the transcripts; both deductive and inductive coding were used to analyze the transcripts.

Results  Three focus groups including 15 adolescents (8 male) with a mean age of 15.3 (range, 12-18) years were conducted. Adolescents were in general satisfied with the efficacy of the treatment; however, they prefer a faster and more persistent effect. Most adolescents had little contact with their physicians and did not completely adhere to the prescribed medication regimen; they developed their own routine of using topical corticosteroids in combination with emollients and moisturizers. They also seemed to have incorrect beliefs about the mechanism of action.

Conclusions and Relevance  Adolescents developed their own way of using topical treatment for atopic dermatitis. Some practical suggestions were mentioned to improve medication use. Health care providers should devote special attention to adolescents with atopic dermatitis to make them more aware of the principles of topical treatment and ensure proper use.