The effects of season and weather on healthcare utilization among patients with atopic dermatitis

C R Hamann; Y M F Andersen; K A Engebretsen; L. Skov; J I Silverberg; A Egeberg; J.P. Thyssen

doi:10.1111/jdv.15023

The effects of season and weather on healthcare utilization among patients with atopic dermatitis

C R Hamann, Y M F Andersen, K A Engebretsen, L. Skov, J I Silverberg, A Egeberg, J.P. Thyssen

Institut for Klinisk Medicin

12 Citationer (Scopus)

Abstract

BACKGROUND: Patient-reported triggers for atopic dermatitis (AD) flares include changes in ultraviolet irradiation, humidity and temperature.

OBJECTIVES: To identify the relationships between weather data and healthcare utilization in AD patients.

METHODS: Using nationwide healthcare registries, clinic (1994-2012) and hospital visits (1977-2012) for AD treatment were calculated as well as monthly totals of topical corticosteroid (TCS) (1996-2012) and calcineurin inhibitor (TCI) prescriptions (2003-20012) filled by AD patients. We calculated monthly averages of temperature, atmospheric pressure, cloud cover and hours of bright sunlight and compared these variables to healthcare utilization endpoints, for the years 2000-2012 (n = 156 months), using linear regression models.

RESULTS: In Denmark, between the year 2000 and 2012, mean monthly totals of AD emergency room visits were 6, AD hospitalizations 32, AD outpatient visits 170, TCS prescriptions filled by AD patients 3811 and TCI prescriptions 2552. Healthcare utilization among AD patients was highest in winter/spring. Temperature was the environmental variable that had the strongest association with healthcare utilization: per 1°C lower monthly temperature, 2 more (95% confidence interval [CI] 1-4) AD clinic/hospital visits hospitalizations were observed, 18 (95% CI 9-26) more TCS prescriptions and 53 (95% CI 36-70) more TCI prescriptions were filled by patients with AD. Environmental variables were highly correlated. Associations between AD healthcare utilization and hours of cloud cover were generally positive, while those with hours of bright sunlight were generally inverse.

CONCLUSIONS: AD healthcare utilization markers changed significantly with season. A decline in temperature correlated well with AD patients' healthcare utilization, but a causative role could not be determined with certainty.

Originalsprog	Engelsk
Tidsskrift	Journal of the European Academy of Dermatology and Venereology : JEADV
Vol/bind	32
Udgave nummer	10
Sider (fra-til)	1745-1753
Antal sider	9
ISSN	0926-9959
DOI	https://doi.org/10.1111/jdv.15023
Status	Udgivet - okt. 2018

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10.1111/jdv.15023

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@article{22ed4af3144644fda9d7d93c0b5bace5,

title = "The effects of season and weather on healthcare utilization among patients with atopic dermatitis",

abstract = "BACKGROUND: Patient-reported triggers for atopic dermatitis (AD) flares include changes in ultraviolet irradiation, humidity and temperature.OBJECTIVES: To identify the relationships between weather data and healthcare utilization in AD patients.METHODS: Using nationwide healthcare registries, clinic (1994-2012) and hospital visits (1977-2012) for AD treatment were calculated as well as monthly totals of topical corticosteroid (TCS) (1996-2012) and calcineurin inhibitor (TCI) prescriptions (2003-20012) filled by AD patients. We calculated monthly averages of temperature, atmospheric pressure, cloud cover and hours of bright sunlight and compared these variables to healthcare utilization endpoints, for the years 2000-2012 (n = 156 months), using linear regression models.RESULTS: In Denmark, between the year 2000 and 2012, mean monthly totals of AD emergency room visits were 6, AD hospitalizations 32, AD outpatient visits 170, TCS prescriptions filled by AD patients 3811 and TCI prescriptions 2552. Healthcare utilization among AD patients was highest in winter/spring. Temperature was the environmental variable that had the strongest association with healthcare utilization: per 1°C lower monthly temperature, 2 more (95% confidence interval [CI] 1-4) AD clinic/hospital visits hospitalizations were observed, 18 (95% CI 9-26) more TCS prescriptions and 53 (95% CI 36-70) more TCI prescriptions were filled by patients with AD. Environmental variables were highly correlated. Associations between AD healthcare utilization and hours of cloud cover were generally positive, while those with hours of bright sunlight were generally inverse.CONCLUSIONS: AD healthcare utilization markers changed significantly with season. A decline in temperature correlated well with AD patients' healthcare utilization, but a causative role could not be determined with certainty.",

keywords = "Administration, Cutaneous, Adolescent, Adrenal Cortex Hormones/administration & dosage, Adult, Ambulatory Care/statistics & numerical data, Atmospheric Pressure, Calcineurin Inhibitors/therapeutic use, Denmark, Dermatitis, Atopic/therapy, Drug Prescriptions/statistics & numerical data, Emergency Service, Hospital/statistics & numerical data, Female, Health Services/statistics & numerical data, Hospitalization/statistics & numerical data, Humans, Male, Registries, Seasons, Sunlight, Temperature, Young Adult",

author = "Hamann, {C R} and Andersen, {Y M F} and Engebretsen, {K A} and L. Skov and Silverberg, {J I} and A Egeberg and J.P. Thyssen",

year = "2018",

month = oct,

doi = "10.1111/jdv.15023",

language = "English",

volume = "32",

pages = "1745--1753",

journal = "Journal of the European Academy of Dermatology and Venereology : JEADV",

issn = "0926-9959",

publisher = "Elsevier",

number = "10",

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TY - JOUR

T1 - The effects of season and weather on healthcare utilization among patients with atopic dermatitis

AU - Hamann, C R

AU - Andersen, Y M F

AU - Engebretsen, K A

AU - Skov, L.

AU - Silverberg, J I

AU - Egeberg, A

AU - Thyssen, J.P.

PY - 2018/10

Y1 - 2018/10

N2 - BACKGROUND: Patient-reported triggers for atopic dermatitis (AD) flares include changes in ultraviolet irradiation, humidity and temperature.OBJECTIVES: To identify the relationships between weather data and healthcare utilization in AD patients.METHODS: Using nationwide healthcare registries, clinic (1994-2012) and hospital visits (1977-2012) for AD treatment were calculated as well as monthly totals of topical corticosteroid (TCS) (1996-2012) and calcineurin inhibitor (TCI) prescriptions (2003-20012) filled by AD patients. We calculated monthly averages of temperature, atmospheric pressure, cloud cover and hours of bright sunlight and compared these variables to healthcare utilization endpoints, for the years 2000-2012 (n = 156 months), using linear regression models.RESULTS: In Denmark, between the year 2000 and 2012, mean monthly totals of AD emergency room visits were 6, AD hospitalizations 32, AD outpatient visits 170, TCS prescriptions filled by AD patients 3811 and TCI prescriptions 2552. Healthcare utilization among AD patients was highest in winter/spring. Temperature was the environmental variable that had the strongest association with healthcare utilization: per 1°C lower monthly temperature, 2 more (95% confidence interval [CI] 1-4) AD clinic/hospital visits hospitalizations were observed, 18 (95% CI 9-26) more TCS prescriptions and 53 (95% CI 36-70) more TCI prescriptions were filled by patients with AD. Environmental variables were highly correlated. Associations between AD healthcare utilization and hours of cloud cover were generally positive, while those with hours of bright sunlight were generally inverse.CONCLUSIONS: AD healthcare utilization markers changed significantly with season. A decline in temperature correlated well with AD patients' healthcare utilization, but a causative role could not be determined with certainty.

AB - BACKGROUND: Patient-reported triggers for atopic dermatitis (AD) flares include changes in ultraviolet irradiation, humidity and temperature.OBJECTIVES: To identify the relationships between weather data and healthcare utilization in AD patients.METHODS: Using nationwide healthcare registries, clinic (1994-2012) and hospital visits (1977-2012) for AD treatment were calculated as well as monthly totals of topical corticosteroid (TCS) (1996-2012) and calcineurin inhibitor (TCI) prescriptions (2003-20012) filled by AD patients. We calculated monthly averages of temperature, atmospheric pressure, cloud cover and hours of bright sunlight and compared these variables to healthcare utilization endpoints, for the years 2000-2012 (n = 156 months), using linear regression models.RESULTS: In Denmark, between the year 2000 and 2012, mean monthly totals of AD emergency room visits were 6, AD hospitalizations 32, AD outpatient visits 170, TCS prescriptions filled by AD patients 3811 and TCI prescriptions 2552. Healthcare utilization among AD patients was highest in winter/spring. Temperature was the environmental variable that had the strongest association with healthcare utilization: per 1°C lower monthly temperature, 2 more (95% confidence interval [CI] 1-4) AD clinic/hospital visits hospitalizations were observed, 18 (95% CI 9-26) more TCS prescriptions and 53 (95% CI 36-70) more TCI prescriptions were filled by patients with AD. Environmental variables were highly correlated. Associations between AD healthcare utilization and hours of cloud cover were generally positive, while those with hours of bright sunlight were generally inverse.CONCLUSIONS: AD healthcare utilization markers changed significantly with season. A decline in temperature correlated well with AD patients' healthcare utilization, but a causative role could not be determined with certainty.

KW - Administration, Cutaneous

KW - Adolescent

KW - Adrenal Cortex Hormones/administration & dosage

KW - Adult

KW - Ambulatory Care/statistics & numerical data

KW - Atmospheric Pressure

KW - Calcineurin Inhibitors/therapeutic use

KW - Denmark

KW - Dermatitis, Atopic/therapy

KW - Drug Prescriptions/statistics & numerical data

KW - Emergency Service, Hospital/statistics & numerical data

KW - Female

KW - Health Services/statistics & numerical data

KW - Hospitalization/statistics & numerical data

KW - Humans

KW - Male

KW - Registries

KW - Seasons

KW - Sunlight

KW - Temperature

KW - Young Adult

U2 - 10.1111/jdv.15023

DO - 10.1111/jdv.15023

M3 - Journal article

C2 - 29706020

SN - 0926-9959

VL - 32

SP - 1745

EP - 1753

JO - Journal of the European Academy of Dermatology and Venereology : JEADV

JF - Journal of the European Academy of Dermatology and Venereology : JEADV

IS - 10

ER -

The effects of season and weather on healthcare utilization among patients with atopic dermatitis

Abstract

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