Disease burden and treatment‑seeking behaviour of adults with atopic dermatitis in singapore: an online cross‑sectional survey

Abstract

Introduction: Atopic dermatitis (AD) is a chronic systemic inflammatory skin disease with a notably high prevalence in Singapore. Despite available treatments, a significant proportion of patients remain untreated, highlighting a critical need to understand treatment-seeking behaviours and address the multi-faceted disease burden. Methods: An online survey was conducted among 344 adult patients and caregivers answering on behalf of patients to obtain data on clinical impact and quality-of life (QoL), current treatment goals, management, financial impact and treatment-seeking behaviours. This study analysed the differences between patients with different AD severity using data initially collected in Excel and processed in SPSS. Results: AD patients in Singapore face challenges like self-consciousness due to appearance (38%), treatment costs (36%) and the need for additional skincare (34%), with severe AD patients significantly more affected by these issues. Key symptoms like skin dryness (61%), itchiness (56%) and red/scaly skin (48%) worsen with disease severity. AD's impact on patients intensifies with severity, with 100% of severe AD patients rating their condition as 'very serious', correlating with a higher Dermatology Life Quality Index (DLQI) score. Management strategies for AD flare-ups include lifestyle changes (53%) and home remedies (48%). Financial burden is considerable, averaging US dollars (USD) 1368 per month, with 82% perceiving it as 'extreme', affecting treatment adherence. Conclusion: The study underscores the significant burden and impact on QoL faced by adult AD patients in Singapore. It highlights the necessity for targeted research on economic impacts and treatment behaviours in specific groups and the urgent need for effective interventions to enhance QoL, particularly for those with severe AD.