Patient treatment needs in atopic dermatitis: A real‐world cohort study

BACKGROUND: Atopic dermatitis (AD) substantially affects quality of life, yet standardized severity measures may not capture patient-centred priorities, making systematic needs assessment essential for personalized care. OBJECTIVES: This study aimed to systematically assess and rank treatment needs in adults with moderate to severe AD, identify patient subgroups with distinct need profiles and evaluate how well these needs were met after 2 years of specialized dermatological care. METHODS: In this prospective observational study from the TREATgermany registry, 697 adults with moderate to severe AD completed the validated Patient Benefit Index (PBI) at baseline (T1) and at 2-year follow-up (T2), capturing treatment goal importance and achievement. Subgroup analyses were performed based on age, sex, educational status and age at AD onset. Associations between clinical measures and perceived benefit were analysed. RESULTS: The most frequently prioritized treatment goals were being free of itching (97.8% high agreement), regaining control of the disease (95.3%) and relief from skin burning (92.0%). The importance of itch reduction was not correlated with baseline pruritus intensity, and perceived benefit was more closely linked to relative clinical improvement than to absolute disease severity. Beyond these shared priorities, treatment needs varied across subgroups: older patients valued treatment safety and reduced dependence on medical care, women emphasized psychosocial and appearance-related goals, individuals with lower educational status highlighted financial concerns and patients with adult-onset AD prioritized diagnostic certainty and disease control. After 2 years, 96.6% of patients reported meaningful treatment benefit. Patient-reported outcomes (POEM) were more strongly associated with perceived benefit than physician-assessed measures (oSCORAD, EASI). CONCLUSION: Patient treatment needs in AD vary by demographic and clinical factors, with pruritus consistently rated as the highest priority. Patient-reported outcomes align more closely with perceived benefit than physician assessments, underscoring the value of systematic needs assessments to guide individualized treatment decisions and shared decision-making.

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Journal
Journal of the European Academy of Dermatology and Venereology
Published
2026-07-30
DOI
https://doi.org/10.1111/jdv.70648
Primary Topic
Dermatology and Skin Diseases
Type
article
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article

Patient treatment needs in atopic dermatitis: A real‐world cohort study

Dora Stölzl, Andreas Pinter, Matthias Augustin, Kathrin Meinhardt et al.
Journal of the European Academy of Dermatology and Venereology
Dermatology and Skin Diseases
article

Patient treatment needs in atopic dermatitis: A real‐world cohort study

Dora Stölzl, Andreas Pinter, Matthias Augustin, Kathrin Meinhardt, Stephan Traidl, Michael Sticherling, Christiane Handrick, Luise Heinrich, T. Honstein, Beate Schwarz, Thomas Werfel, M. Schulz-Kiesow, S Anders, Jutta Ramaker‐Brunke, Inken Harder, Maren Stahl, Sven Quist, Annice Heratizadeh, Jochen Schmitt, Nicole Adler, Anke Herrmann, Knut Schäkel, Barbara Kind, Stephan Weidinger, Caroline Mann, Mohammad Asefi, Susanne Abraham, Thomas Schaefer, Joëlle Naim, Angela Cornelius, Tilo Biedermann, the TREATgermany study group, Anne Bong, Kristina Ludemann
article en

Abstract

BACKGROUND: Atopic dermatitis (AD) substantially affects quality of life, yet standardized severity measures may not capture patient-centred priorities, making systematic needs assessment essential for personalized care. OBJECTIVES: This study aimed to systematically assess and rank treatment needs in adults with moderate to severe AD, identify patient subgroups with distinct need profiles and evaluate how well these needs were met after 2 years of specialized dermatological care. METHODS: In this prospective observational study from the TREATgermany registry, 697 adults with moderate to severe AD completed the validated Patient Benefit Index (PBI) at baseline (T1) and at 2-year follow-up (T2), capturing treatment goal importance and achievement. Subgroup analyses were performed based on age, sex, educational status and age at AD onset. Associations between clinical measures and perceived benefit were analysed. RESULTS: The most frequently prioritized treatment goals were being free of itching (97.8% high agreement), regaining control of the disease (95.3%) and relief from skin burning (92.0%). The importance of itch reduction was not correlated with baseline pruritus intensity, and perceived benefit was more closely linked to relative clinical improvement than to absolute disease severity. Beyond these shared priorities, treatment needs varied across subgroups: older patients valued treatment safety and reduced dependence on medical care, women emphasized psychosocial and appearance-related goals, individuals with lower educational status highlighted financial concerns and patients with adult-onset AD prioritized diagnostic certainty and disease control. After 2 years, 96.6% of patients reported meaningful treatment benefit. Patient-reported outcomes (POEM) were more strongly associated with perceived benefit than physician-assessed measures (oSCORAD, EASI). CONCLUSION: Patient treatment needs in AD vary by demographic and clinical factors, with pruritus consistently rated as the highest priority. Patient-reported outcomes align more closely with perceived benefit than physician assessments, underscoring the value of systematic needs assessments to guide individualized treatment decisions and shared decision-making.

Journal of the European Academy of Dermatology and Venereology
Goethe University Frankfurt (DE), Universität Hamburg (DE), Rohde & Schwarz (Germany) (DE), Heidelberg University (DE), Wockhardt (United States) (US), Universitätsmedizin Greifswald (DE), German Center for Neurodegenerative Diseases (DE), University Hospital Heidelberg (DE), Medizinische Hochschule Hannover (DE), Stahl-Zentrum (Germany) (DE), MED Institute (US), Hanover University of Music Drama and Media (DE), Ambulatory Rehabilitation Center Berlin Adlershof (DE), University Medical Center Hamburg-Eppendorf (DE), University Hospital Schleswig-Holstein (DE), Helmholtz Institute Mainz (DE), Klinikum Braunschweig (DE), München Klinik (DE), University Hospital Frankfurt (DE), University Dermatology (US), Advanced Simulation & Design (Germany) (DE), St. Anna Hospital (DE), University Hospital Carl Gustav Carus (DE), Technical University of Munich (DE), University of Lübeck (DE)
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