Education underpins improved eczema management: report


By Mardi Chapman

12 Sep 2023

A National Eczema Strategy would tackle issues from steroid phobia to the dermatologist shortage in an effort to redress the current suboptimal management of the disease in Australia.

In its report, The Burden of Eczema – Evidence for a National Strategy [link here], Eczema Support Australia said a 2022 patient survey had revealed that only 34% of children and 61% of adults achieve long-term control of their eczema.

It said the story was complicated by “corticophobia” – a major source of treatment non-compliance and treatment failure.

The report, supported by the Australasian College of Dermatologists (ACD), said patients with eczema, parents of children with eczema and health professionals were all susceptible to fear and anxiety regarding the safety of topical corticosteroids.

Other challenges included limited access to systemic treatments such as biologics and JAK inhibitors for patients with moderate to severe eczema.

In the Reports’ Foreword, ACD president Dr Adriene Lee wrote that misplaced fear of topical corticosteroids often leads to their underuse, resulting in unnecessary disease flares.

“This has long been a concern of the College. However, until there is a coordinated effort to change these perceptions in general practice and pharmacy, Australians will experience avoidable and unnecessarily severe disease flares.”

“We also endorse the report’s finding that there is a nationwide shortage of dermatologists, with just over 600 dermatologists to meet the skin health needs of 26 million Australians, and limited levels of dermatology education in medical schools and in general practice, where the majority of people with the condition are managed.”

The Report said eczema had a substantial impact on patients’ psychosocial well-being and quality of life and on family stress related to the care of children with moderate to severe eczema.

There was also a heavy financial burden from eczema on patients, their families and the health system.

The Report called for a a National Eczema Strategy to:

  • Standardise care to end treatment maze
  • Address steroid phobia which leads to eczema flare-ups
  • Prevent hospitalisation and manage co-morbidities
  • Ensure equitable access to treatment
  • Increase health literacy through patient education and support
  • End isolation via government funding to Eczema Support Australia
  • Bolster dermatology training for GPs, nurses and Aboriginal health workers
  • Improve transitions from paediatric and adolescent to adult care
  • Address dermatologist shortage (only 2.3 specialists per 100,000 Australians)
  • Establish an eczema registry.

It suggested that nurse-led educational interventions for paediatric eczema in some public hospital outpatient clinics could be expanded to other practice settings.

Meanwhile, upskilling of health professionals could be prioritised using the existing CPD resources of Dermatology Australasia, the Skin Health Institute, the Australian Dermatology Nurses’ Association and the RACGP.

The Burden of Eczema – Evidence for a National Strategy was financially supported by Sanofi Australia and Pfizer Australia.

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