Versorgung von chronisch entzündlichen Hauterkrankungen

Disease-Related Internet Use and its Relevance to the Patient-Physician Relationship in Atopic Dermatitis: A Cross-Sectional Study in Germany

Background: Health-related internet use presents both opportunities and challenges for patients and physicians and requires a comprehensive understanding to improve individual health care in atopic dermatitis (AD). Objective: To explore differences between regular and irregular disease-related internet users, reasons for disease-related internet use, and its relevance to the patient-physician relationship in AD. Methods: This cross-sectional study recruited 221 adults with AD online and from a German university clinic between August 2021 and February 2022. The questionnaire queried sociodemographic and disease-related information, reasons for and against using the internet, types of channels used, and the impact on the patient-physician relationship. Participants were categorized as regular (≥once per month) and irregular ( Collapse

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Affiliation(s)

Fabian Wallnöfer From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
Stefanie Ziehfreund From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
Hannah Wecker From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
Barbara Schuster From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
Linda Tizek From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
Alphina Kain From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
Tilo Biedermann From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
Alexander Zink From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden

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Eczema-related Web Search Data in Sweden: Investigating Search Patterns and the Influence of Weather

As atopic eczema is triggered by environmental factors, such as temperature, differences in disease burden between and within countries are possible. One method to study this phenomenon is to perform web-search analysis, since the internet is commonly used to retrieve health-related information. This study, investigating the Google search volume regarding eczema in Swedish counties between April 2017 and March 2021, revealed a continuous increase in number of searches and that the search volume was higher in Northern than Southern Sweden. Gotland had the most searches per 100,000 inhabitants. In general, there was a negative correlation between search volume and temperature (r=-0.315, p < 0.001) and hours of sunshine (r=-0.213, p < 0.001), whereas there was a positive association between search volume and wind (r=0.229, p < 0.001). Search engine analysis is a rapid and cost-effective method of examining search behaviour regarding disease among the general population within a country and, thus, can enable the identification of regions with specific interests and needs.

Munich atopy prediction study (MAPS): protocol for a prospective birth cohort addressing clinical and molecular risk factors for atopic dermatitis in early childhood

INTRODUCTION

The pathogenesis of atopic diseases is highly complex, and the exact mechanisms leading to atopic dermatitis (AD) onset in infants remain mostly enigmatic. In addition to an interdependent network of components of skin development in young age and skin barrier dysfunction underlying AD development that is only partially understood, a complex interplay between environmental factors and lifestyle habits with skin barrier and immune dysregulation is suspected to contribute to AD onset. This study aims to comprehensively evaluate individual microbiome and immune responses in the context of environmental determinants related the risk of developing AD in the first 4 years of a child's life.

METHODS AND ANALYSES

The 'Munich Atopic Prediction Study' is a comprehensive clinical and biological investigation of a prospective birth cohort from Munich, Germany. Information on pregnancy, child development, environmental factors, parental exposures to potential allergens and acute or chronic diseases of children and parents are collected by questionnaires together with a meticulous clinical examination by trained dermatologists focusing on allergies, skin health, and in particular signs of AD at 2 months after birth and then every 6 months. In addition, skin barrier functions are assessed through cutometry, corneometry and transepidermal water loss at every visit. These measurements are completed with allergy diagnostics and extensive microbiome analyses from stool and skin swabs as well as transcriptome analyses using skin microbiopsies.The aim is to assess the relevance of different known and yet unknown risk factors of AD onset and exacerbations in infants and to identify possible accessible and robust biomarkers.

ETHICS AND DISSEMINATION

The study is approved by the Ethical Committee of the Medical Faculty of the Technical University of Munich (reference 334/16S). All relevant study results will be presented at national and international conferences and in peer-reviewed journals.

[Atopic dermatitis-identifying needs in the German population by internet search queries]

Hintergrund

Das Internet ist eine der wichtigsten Informationsquellen für gesundheitliche Themen für die Allgemeinbevölkerung. Deshalb kann die Analyse von Internetsuchmaschinen dabei helfen, die gesellschaftlichen Interessen und Bedürfnisse bezüglich Erkrankungen zu erfassen.

Ziel

Ziel dieser Studie war es, die Suchanfragen zu atopischer Dermatitis (AD) in Bezug auf Häufigkeit, Interessenschwerpunkt und zeitliches Auftreten in allen deutschen Bundesländern zu untersuchen, um mögliche regionale Unterschiede zu identifizieren.

Material und Methoden

Mithilfe des Google Ads Keyword Planner wurden AD relevante Keywords inklusive deren monatlichen Suchvolumens zwischen Januar 2017 und Dezember 2020 identifiziert, die in Interessenschwerpunkte unterteilt wurden.

Ergebnisse

Es wurden 1419 Keywords gefunden, die ein Suchvolumen von 14.817.610 Anfragen hatten. Das größte Suchvolumen hatte die Kategorie Allgemein (n = 5.970.840), jedoch wurden der Kategorie Lokalisation die meisten Keywords zugeordnet (n = 348). Rund 60 % der Keywords zu Lokalisation bezogen sich auf AD im Gesicht. Von allen Bundesländern hatten Bremen und Hamburg das größte Suchvolumen pro 100.000 Einwohner. Mit über 70 % war ein enormer Anstieg im Suchvolumen zu beobachten, der v. a. 2020 sichtbar wurde.

Diskussion

Durch diese Internetsuchmaschinenanalyse konnte verdeutlicht werden, welche AD-relevanten Aspekte von besonderer Bedeutung für die Bevölkerung waren, was dabei helfen kann, Informationskampagnen zielgerichtet anzupassen. Zudem unterstreicht die Studie die immer größer werdende Relevanz des Internets als Informationsquelle für gesundheitliche Themen.

Zusatzmaterial online

Die Online-Version dieses Beitrags (10.1007/s00105-022-04974-x) enthält zusätzliche Tabellen. Beitrag und Zusatzmaterial stehen Ihnen im elektronischen Volltextarchiv auf https://www.springermedizin.de/der-hautarzt zur Verfügung. Sie finden das Zusatzmaterial am Beitragsende unter „Supplementary Information“.

[Web search data as health data? : Geographic differences, temporal trends, and topics of interest from internet search engine analyses in Germany]

Hintergrund

Die eingeschränkt zeitnahe, kostengünstige und regionale Verfügbarkeit von Daten im Gesundheitswesen gilt als einer der limitierenden Faktoren für zeitgerechte Analysen im Bereich der Versorgungsforschung und damit für die Gesundheitsversorgung der allgemeinen Bevölkerung. Deshalb geraten zunehmend Internetsuchmaschinenanalysen in den Fokus.

Fragestellung

Welchen Beitrag können Daten zum Internetsuchvolumen zu verschiedenen Erkrankungen in der Gesundheitsversorgung der deutschen Bevölkerung leisten? Wo liegt das Potenzial, und wo gibt es Grenzen?

Material und Methoden

Es erfolgten die Aufbereitung der aktuellen Literatur sowie eine selektive Übersicht der in den letzten 4 Jahren veröffentlichten Suchmaschinenanalysen zu dermatologischen, allergologischen und infektiologischen Erkrankungen in Deutschland.

Ergebnisse

Durch die Analyse von Suchmaschinendaten konnten zeitliche Entwicklungen wie Saisonalität, Monate mit dem höchsten Suchinteresse und geografische Unterschiede auf nationaler, Bundesländer- und Städteebene abgebildet und Interessenschwerpunkte bezüglich eines die Krankheit betreffenden Themas (z. B. Hautkrebs am Auge oder analer Juckreiz) aufgezeigt werden. Darüber hinaus fanden manche Studien einen Zusammenhang zwischen dem Suchvolumen und externen Faktoren (z. B. Temperatur, ärztliche Versorgungsstruktur) sowie zu registrierten Fällen (z. B. Hautkrebs, Borreliose).

Schlussfolgerung

Internetsuchmaschinendaten liefern als nahezu in Echtzeit verfügbare Datenquelle unter Berücksichtigung der aufgezeigten Fallstricke ein räumlich-zeitliches Abbild hinsichtlich der Bedürfnisse der internetnutzenden Bevölkerung. Sie können besonders nützlich in Situationen sein, in denen traditionelle Gesundheitsdaten begrenzt oder nicht vorhanden sind.

Zusatzmaterial online

Die Online-Version dieses Beitrags (10.1007/s00105-021-04918-x) enthält eine zusätzliche Tabelle. Beitrag und Zusatzmaterial stehen Ihnen im elektronischen Volltextarchiv auf https://www.springermedizin.de/der-hautarzt zur Verfügung. Sie finden das Zusatzmaterial am Beitragsende unter „Supplementary Information“.

Trotz einer großen Auswahl wirksame Medikamente: Psoriatiker scheinen immer noch untertherapiert zu sein

HINTERGRUND UND ZIELE

Durch die Entwicklung neuer anti-psoriatischer Medikamente und verbesserte Strukturen zu deren flächendeckender Einführung hat sich die medizinische Versorgung von Psoriasis-Patienten deutlich verbessert. In dieser Studie haben wir die tatsächliche Inanspruchnahme des Gesundheitswesens untersucht und Gründe für die Unzufriedenheit der Betroffenen ermittelt.

PATIENTEN UND METHODIK

Diese nicht-interventionelle Querschnittsstudie wurde als anonyme Online-Befragung von 12/2018 bis 01/2019 in Deutschland durchgeführt. Teilnehmer mit einer selbstberichteten, von einem Arzt gestellten Psoriasis-Diagnose und Symptomen beantworteten Fragen zu ihrer Erkrankung, deren Einfluss auf das tägliche Leben und ihrer medizinischen Versorgung.

ERGEBNISSE

649 Teilnehmer mit einem mittleren Alter von 42,5 ± 13,7 Jahren und ausgewogener Geschlechterverteilung (männlich: 50,2 %) wurden ausgewertet. 54,1 % waren zum Zeitpunkt der Studie in ärztlicher Behandlung, 45,9 % nicht. Von den Teilnehmern mit medizinischer Versorgung waren 59,3 % nur mäßig oder weniger zufrieden mit ihrer Behandlung. Gründe für die Unzufriedenheit mit der Medikation waren unter anderem mangelnde Wirksamkeit und Nebenwirkungen. Von den nicht in ärztlicher Behandlung befindlichen Teilnehmern wurde "Zeitmangel des Arztes" als Hauptgrund für die Nichtinanspruchnahme ärztlicher Hilfe angegeben.

SCHLUSSFOLGERUNGEN

Trotz der Verfügbarkeit effizienter Therapieoptionen in Deutschland sind viele Betroffene mit Psoriasis unzufrieden. Diese unterbehandelte Gruppe wurde als neue Zielgruppe identifiziert.

Despite large choice of effective therapies: Individuals with psoriasis still seem undertreated

BACKGROUND AND OBJECTIVES

Due to the development of new anti-psoriatic drugs in combination with improved structures for implementation throughout Germany, the medical care of psoriasis patients has markedly improved. In this study we investigated the real-life utilization of the health care system and identified reasons for dissatisfaction in affected individuals.

PATIENTS AND METHODS

This non-interventional cross-sectional study was conducted as an anonymous online survey from 12/2018 to 01/2019 in Germany. Participants with a self-reported physician-confirmed diagnosis of psoriasis and symptoms answered questions about their disease, its influence on daily life and their medical care.

RESULTS

649 participants with a mean age of 42.5 ± 13.7 years and equal gender distribution (male: 50.2 %) were evaluated. 54.1 % received medical treatment at the time of the study, 45.9 % did not. Among the participants with medical care, 59.3 % were only moderately or less satisfied with their treatment. Reasons for dissatisfaction with the medication included lack of efficacy and side effects. Participants without medical treatment specified a physician's lack of time as a main reason for not seeking medical help.

CONCLUSIONS

Despite the availability of efficient therapeutic options in Germany, many individuals with psoriasis are not satisfied. This under-treated group was identified as a new target population.

People-centered care for psoriasis and urticaria: Are we overlooking Internet addiction while only considering patients and physician settings?

Psoriasis and chronic urticaria (CU) are chronic skin diseases with a high impact on individuals' life and mental health. Some studies indicate a high prevalence of Internet addiction and many affected individuals seem not to utilize healthcare, but rather search for health-related information online. The aims of the study were to assess Internet addiction as a potential comorbidity in both diseases as well as identify differences in healthcare utilization between individuals with psoriasis and CU. This cross-sectional study is based on self-reported data from individuals with psoriasis and CU living throughout Germany using the framework of an online survey from 12/2018 to 01/2019. Advertisements on Google and Facebook were used to address Internet users who searched online for information on psoriasis or CU. The study questionnaire comprised questions on demographics, current contact with physicians, and disease history as well as validated screening tools for well-being and Internet addiction. Overall, 1686 participants (74.0% female, 38.5% psoriasis) with a mean age of 36.9 ± 12.9 years were analyzed. Participants with CU were more likely female (89.2% vs 49.8%, P < 0.001) and not in medical care compared to participants with psoriasis (60.3% vs 45.9%, P < 0.001). Sixteen percent of the participants overall were screened positive for Internet addiction. Furthermore, not utilizing medical care showed a significant association with being screened positive for Internet addiction in participants with CU (adjusted odds ratio [aOR] = 1.49, 95% confidence interval [CI] 1.10-2.02), but not in those with psoriasis. The study revealed a high proportion of affected individuals not being in medical care and a high prevalence of Internet addiction, with individuals with CU not utilizing medical resources having a higher chance of being screened positive for Internet addiction. This underlines the approach of people-centered care and highlights its importance for further research.

Always Online? Internet Addiction and Social Impairment in Psoriasis across Germany

With the World Health Organization (WHO) demanding further investigation of the social impairment and psychosocial burden of psoriasis, a first study identified a high prevalence of Internet addiction. The aim of this study was to assess social impairment and estimate the occurrence of Internet addiction along with depression, cigarette smoking, and alcohol dependency in individuals with psoriasis recruited online in a people-centered care approach. A cross-sectional online survey was carried out across Germany between March 2019 and June 2019. The questionnaire contained information on social impairment, smoking habits, as well as validated questionnaires on Internet addiction, depression, and alcohol dependency. Overall, 460 individuals (62.4% female; mean age: 45.9 ± 13.7 years) with psoriasis were included. Of those, 406 (88.3%) stated to be at least rarely socially impaired. The positive screening rate for Internet addiction was 8.5%. Furthermore, 40.0% had positive screenings for depression, 17.1% for alcohol dependency, and 32.6% for daily smoking. Positive screenings for Internet addiction and alcohol dependency were substantially more frequent in individuals with psoriasis than in the German general population. In order to meet the demands of the WHO, Internet addiction could be considered as a potential comorbidity in psoriasis and a focus on people-centered care is advisable for further research.