How Patients with Atopic Dermatitis Experience Topical Therapy: A Real-World Analysis of Impact, Treatment Satisfaction, and HCP Communication

INTRODUCTION: Atopic dermatitis (AD) is a chronic, burdensome skin condition with significant impact on quality of life. Topical therapies are recommended as first-line treatment; however, patients with moderate-to-severe disease or inadequate disease control may require escalation to systemic therapy. Despite the central role of topical therapies in AD management, real-world data on treatment satisfaction and healthcare provider (HCP)-patient concordance remain limited. METHODS: This analysis draws on data from the Adelphi Real World Atopic Dermatitis Topical Plus Wave I Disease Specific Programme (DSP)™, a cross-sectional, real-world survey conducted in 2025 among 267 US adolescents and adults with current moderate-to-severe AD. Using linked surveys, we evaluated treatment satisfaction and communication dynamics between HCPs and patients/caregivers using topical therapies, both with and without advanced systemic therapy. Kappa analysis assessed HCP-patient/caregiver agreement. RESULTS: At time of survey completion, 233 participants had moderate AD (87%), as assessed by a HCP, with 34 participants (13%) having severe AD. Participants in both the topical medication only (TM) (n = 193; 72%) and topical plus advanced systemic therapy (TAS) (n = 74; 28%) groups reported day-to-day impacts on clothing choices, daily activities, and sleep. Notably, 68% of patients using topical therapies reported disliking how their topical therapy made their skin feel, underscoring a persistent daily treatment burden. Regarding satisfaction, moderate concordance between patient/caregiver and HCP ratings was observed among individuals receiving TM (κ = 0.57; p < 0.001) and those with moderate AD (κ = 0.46; p < 0.001), with fair concordance among patients/caregivers receiving TAS (κ = 0.27; p = 0.001) and those with severe AD (κ = 0.25; p = 0.031). Communication analysis revealed moderate concordance between HCPs and patients/caregivers with respect to instructions for application amount (TM: κ = 0.54, p < 0.001; TAS κ = 0.42, p < 0.001). CONCLUSIONS: These findings highlight persistent gaps in satisfaction and communication for patients with moderate-to-severe AD prescribed topical medications, underscoring the need for individualized treatment approaches. Addressing these gaps may help address unmet needs and inform more individualized care.