Delay in medical attention to hand eczema: a follow-up study

TY - JOUR

T1 - Delay in medical attention to hand eczema: a follow-up study

AU - Hald, M

AU - Agner, T

AU - Blands, J

AU - Johansen, J D

AU - Danish Contact Dermatitis Group

N1 - Keywords: Adolescent; Adult; Cohort Studies; Denmark; Dermatitis, Occupational; Female; Follow-Up Studies; Hand Dermatoses; Humans; Male; Middle Aged; Odds Ratio; Patch Tests; Prognosis; Questionnaires; Severity of Illness Index; Time Factors; Young Adult

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Hand eczema often runs a chronic course but early medical intervention may be assumed to improve the prognosis. OBJECTIVES: To follow patients with hand eczema for 6 months after seeing a dermatologist to investigate if delay in medical attention would impair the prognosis. METHODS: Study participants were 333 patients with hand eczema from nine dermatological clinics in Denmark. Severity of hand eczema was assessed by the patients at baseline and at the 6-month follow up using a self-administered photographic guide. Additional information was obtained by self-administered questionnaires. RESULTS: Median patient delay (defined as the period from onset of symptoms until seeing a general practitioner) was 3 months [interquartile range (IQR) 1.5-8.0]. The median healthcare delay (defined as the period from the first visit to a general practitioner until seeing a dermatologist) was 3 months (IQR 1-8). In a logistic regression model, the odds ratio of a poor prognosis increased by a factor of 1.11 [95% confidence interval (CI) 1.02-1.21] per month of patient delay and by 1.05 (95% CI 1.00-1.10) per month of healthcare delay. CONCLUSIONS: A poorer prognosis of hand eczema was associated with longer delay before medical attention.

AB - BACKGROUND: Hand eczema often runs a chronic course but early medical intervention may be assumed to improve the prognosis. OBJECTIVES: To follow patients with hand eczema for 6 months after seeing a dermatologist to investigate if delay in medical attention would impair the prognosis. METHODS: Study participants were 333 patients with hand eczema from nine dermatological clinics in Denmark. Severity of hand eczema was assessed by the patients at baseline and at the 6-month follow up using a self-administered photographic guide. Additional information was obtained by self-administered questionnaires. RESULTS: Median patient delay (defined as the period from onset of symptoms until seeing a general practitioner) was 3 months [interquartile range (IQR) 1.5-8.0]. The median healthcare delay (defined as the period from the first visit to a general practitioner until seeing a dermatologist) was 3 months (IQR 1-8). In a logistic regression model, the odds ratio of a poor prognosis increased by a factor of 1.11 [95% confidence interval (CI) 1.02-1.21] per month of patient delay and by 1.05 (95% CI 1.00-1.10) per month of healthcare delay. CONCLUSIONS: A poorer prognosis of hand eczema was associated with longer delay before medical attention.

U2 - 10.1111/j.1365-2133.2009.09402.x

DO - 10.1111/j.1365-2133.2009.09402.x

M3 - Journal article

C2 - 19681880

SN - 0007-0963

VL - 161

SP - 1294

EP - 1300

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 6

ER -