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The effects of season and weather on healthcare utilization among patients with atopic dermatitis
Author(s) -
Hamann C.R.,
Andersen Y.M.F.,
Engebretsen K.A.,
Skov L.,
Silverberg J.I.,
Egeberg A.,
Thyssen J.P.
Publication year - 2018
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.15023
Subject(s) - medicine , medical prescription , atopic dermatitis , confidence interval , health care , emergency department , sunlight , emergency medicine , pediatrics , dermatology , physics , astronomy , psychiatry , economics , pharmacology , economic growth
Abstract Background Patient‐reported triggers for atopic dermatitis ( AD ) flares include changes in ultraviolet irradiation, humidity and temperature. Objectives To identify the relationships between weather data and healthcare utilization in AD patients. Methods Using nationwide healthcare registries, clinic (1994–2012) and hospital visits (1977–2012) for AD treatment were calculated as well as monthly totals of topical corticosteroid ( TCS ) (1996–2012) and calcineurin inhibitor ( TCI ) prescriptions (2003–20012) filled by AD patients. We calculated monthly averages of temperature, atmospheric pressure, cloud cover and hours of bright sunlight and compared these variables to healthcare utilization endpoints, for the years 2000–2012 ( n = 156 months), using linear regression models. Results In Denmark, between the year 2000 and 2012, mean monthly totals of AD emergency room visits were 6, AD hospitalizations 32, AD outpatient visits 170, TCS prescriptions filled by AD patients 3811 and TCI prescriptions 2552. Healthcare utilization among AD patients was highest in winter/spring. Temperature was the environmental variable that had the strongest association with healthcare utilization: per 1°C lower monthly temperature, 2 more (95% confidence interval [ CI ] 1–4) AD clinic/hospital visits hospitalizations were observed, 18 (95% CI 9–26) more TCS prescriptions and 53 (95% CI 36–70) more TCI prescriptions were filled by patients with AD . Environmental variables were highly correlated. Associations between AD healthcare utilization and hours of cloud cover were generally positive, while those with hours of bright sunlight were generally inverse. Conclusions AD healthcare utilization markers changed significantly with season. A decline in temperature correlated well with AD patients’ healthcare utilization, but a causative role could not be determined with certainty.