Versorgungsforschung am Beispiel des Handekzems

Frequency of hand eczema in the elderly: Cross-sectional findings from the German AugUR study

BACKGROUND

Hand eczema (HE) is a chronic inflammatory skin disease caused by a genetic predisposition and environmental exposures. There is a lack of population-based studies on skin diseases in the elderly.

OBJECTIVES

Our aim was to estimate the frequency of HE in the elderly to determine its burden of disease in this particular population.

METHODS

We analyzed data from the research platform AugUR, a study on chronic diseases in the elderly (n = 1133, ages 70-95 years, mean age 77.6, 45.1% women). Raw frequencies were estimated using self-reports on physician-diagnosed HE from a standardized personal interview. Frequencies were standardized to the Bavarian population weighted by gender and 5-year age-groups.

RESULTS

In our sample 2.7% (95% confidence interval [CI] 1.6-4.3) of the paticipants reported to ever have been diagnosed with HE. Among those 57% were male. After standardization, the frequency was estimated at 2.8% (95% CI 1.9-3.9). There were no differences between male and female participants.

CONCLUSIONS

Compared to other studies on lifetime frequency of HE, our estimates seem to be remarkably lower. More in-depth studies with validated diagnoses are warranted to precisely estimate the burden of HE in the elderly.

[Real world data sources for health services research on skin cancer]

Health services research in dermatology with the objective to improve prevention, efficient diagnostics and treatment of skin cancer requires real world data from all sectors. This article provides an overview of currently available relevant real world data sources and the utilization potential. It lists exemplary results of existing studies: secondary data analyses based on billing data from statutory health insurance funds were used among other things to estimate the participation rate in the statutory skin cancer screening. This was approximately 31% in the 2‑year period and was higher in the western German federal states than in the eastern ones. Furthermore, participation was higher for women than for men. Regional data in combination with sociostructural and sociodemographic indicators are available for planning of dermatological care and the analysis points to an association with the prevalence of skin cancer. Primary data are available and necessary for recording patient reported endpoints and evaluating the treatment of skin cancer patients by dermatologists. Extensive histopathological databases record not only clinical markers of skin cancer but also sociodemographic characteristics of the patients and indicate a correlation between the time of diagnosis or therapy and the insurance status and place of residence. In addition to the utilization potential, specific limitations of the data sources are listed.

[Skin, bonding and partnership in atopic dermatitis and psoriasis]

OBJECTIVE

On the basis of attachment, the study combines results in relationship and psychosomatic research. A buffering hypothesis of a secure attachment in patients with chronic skin diseases is checked.

METHODS

Patients with atopic dermatitis (n = 21) and psoriasis (n = 22) were tested with various questionnaires: the German questionnaire for partnership attributes (PFB) and problem list (PL), questionnaire for psychosomatic complaints (BEB), Relationship Scales Questionnaire (RSQ), and a self-designed questionnaire.

RESULTS

Unsecurely attached patients with atopic dermatitis feel mentally more disturbed and report more coherence between mental strains and changes in skin surface than securely attached psoriasis patients. There are tendencies to the assumed buffering effects. The study shows hints of the importance of attachment theory in psychosomatic skin diseases.

CONCLUSION

In the treatment of patients with chronic skin diseases psychosocial aspects should be taken into consideration. Partnership factors might be used as a resource.