Variations in Healthcare Provider Interactions and Treatment Satisfaction by Patient Race and Ethnicity: A Survey of Adults with Atopic Dermatitis.

INTRODUCTION: Understanding how race and ethnicity affect health outcomes in patients with atopic dermatitis (AD) is crucial to optimizing patient-centered care and narrowing health disparities. Here, we aim to explore social drivers of health, treatment experiences, and healthcare professional (HCP) interactions in AD, stratified by patient race and ethnicity. METHODS: This was a cross-sectional, non-interventional, web-based survey study, conducted from September 2023 to December 2023. Participants were recruited through the National Eczema Association and the AmeriSpeak panel. Adult US residents self-reporting a diagnosis of AD completed an electronic survey including questions on AD severity and stress over the last month, current AD treatment satisfaction, AD provider type, and perceptions of HCP interactions. RESULTS: Of 260 survey participants, 55.0% were White, 23.5% were Black/African American, 11.5% were Asian, and 10.0% ("Other") were American Indian/Alaskan Native, Native Hawaiian/Other Pacific Islander, or multiracial; 13.5% of participants were Hispanic/Latino; 43.1% of all participants rated their AD severity as moderate and 7.3% as severe; 37.7% reported being "quite a bit" or "very much" stressed by their AD. While most participants had health insurance and faced few issues procuring essential goods and services, Black/African American and Hispanic/Latino participants had higher uninsurance rates, were least often privately insured, and experienced more procurement issues than other groups; housing insecurity was high among "Other" participants. Most participants reported positive interactions with HCPs, but Black/African American participants most valued HCP cultural similarity, encountered it least often, and were likely to delay or not schedule appointments with culturally dissimilar HCPs. A fifth to a quarter of Black/African American, "Other," and Hispanic/Latino participants did not receive all needed healthcare services for AD, and nearly a third of all participants were dissatisfied with their treatment. Asian participants most frequently reported concerns about interactions with their HCPs, with only half trusting their HCP to effectively treat their AD. CONCLUSION: Race- and ethnicity-related heterogeneity in social drivers of health, treatment experiences, and HCP interactions among patients with AD emphasize the importance of including diverse patient populations in clinical research, highlight the importance of patient-physician concordance and/or HCP cultural sensitivity, and may help inform clinical practice considerations in AD management.

Duke Scholars

Author Amber Reck Atwater Dermatology