Managing Childhood and Adolescent Atopic Dermatitis in Primary Care: A US Expert Group Consensus

This expert-led consensus aims to provide primary care providers (PCPs) with recommendations for the care of atopic dermatitis (AD) in patients aged <18 years. The first point of contact for diagnosis and management of AD is often a PCP, and appropriate, coordinated care between PCPs and AD specialists is essential to optimizing care. A systematic literature review was conducted followed by expert-led development of 25 consensus management recommendations relevant to four key themes in AD management: defining control, current and emerging treatments, referral care pathways, and patient–caregiver experience. Consensus was achieved using a modified Delphi process. For each statement, consensus for inclusion was considered achieved if ≥75% of the experts voted within the 7–9 range on a 9-point scale. Consensus was reached on 24 of 25 statements. Nine statements reached the score of 7–9 by 100% of the experts. Of these, four were pertinent to topical therapy for the management of childhood and adolescent AD in primary care: the need for anti-inflammatory medication to achieve clear or almost clear skin; the need to tailor decisions about therapy to the individual patient/family; the importance of coordinated management between PCPs and specialists as part of effective treatment approaches; and the importance of patient and/or caregiver engagement in shared decision-making. It is hoped that these recommendations will guide the management of pediatric AD in a primary care setting, facilitate coordinated care between PCPs and AD specialists and improve outcomes for patients and their families.