Drug utilization among young adults with atopic dermatitis: Influence of sex, socio-economic status and disease severity

J Eur Acad Dermatol Venereol. 2025 Jan;39(1):145-153. doi: 10.1111/jdv.20076. Epub 2024 May 6.

Abstract

Background: Atopic dermatitis (AD) affects individuals of all ages, and the first-line treatment are emollients and topical corticosteroids. There is insufficient knowledge about factors possibly affecting the drug utilization of young adults with AD.

Objectives: To describe the drug utilization of young adults with AD in relation to sex, socio-economic status and disease severity.

Methods: A cross-sectional study based on the 24-year follow-up from the population-based BAMSE (Children, Allergy, Milieu, Stockholm, Epidemiology Survey) birth cohort linked with dispensing data from the National Drug Register (n = 2912). Self-reported AD and socio-economic status were defined from questionnaire data and disease severity was determined through the clinical examination and Patient-Oriented Eczema Measure questionnaire.

Results: The prevalence of AD in young adults was 17.7% (n = 516) and 45.5% of them were dispensed at least one drug for the treatment of AD during the study period (January 2016 to June 2019). Topical corticosteroids (TCS) were the most common drugs (32.9%) followed by emollients (21.7%). A larger proportion of men were dispensed TCS than women (39.0% vs. 29.1%: p-value = 0.020). A larger proportion of young adults with moderate-to-severe AD were dispensed TCS than those with mild AD (52.6% vs. 35.3%: p-value = 0.026). No one was dispensed the recommended amount of emollients and less than five individuals were dispensed the recommended amount of TCS for mild disease. Male sex (adj.OR 1.54, 95% CI 1.06-2.34) and moderate-to-severe AD (adj.OR 2.62, 95% CI 1.59-4.31) were associated with dispensation of TCS.

Conclusions: A large proportion of young adults with AD was undertreated or untreated. Sex and disease severity did affect the dispensing patterns of investigated drugs.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Cross-Sectional Studies
  • Dermatitis, Atopic* / drug therapy
  • Dermatitis, Atopic* / epidemiology
  • Drug Utilization / statistics & numerical data
  • Emollients / therapeutic use
  • Female
  • Humans
  • Male
  • Severity of Illness Index*
  • Sex Factors
  • Social Class
  • Sweden / epidemiology
  • Young Adult

Substances

  • Emollients
  • Adrenal Cortex Hormones