Cold Weather Prompts More Health Care Utilization in Atopic Dermatitis

Health care utilization in patients with atopic dermatitis (AD) changes significantly based on the season of the year, with low monthly temperatures correlating best with increased health care utilization in these individuals, according to the results of a Danish analysis published in the Journal of the European Academy of Dermatology and Venereology.

The investigators sought to examine the relationship between weather data and health care utilization in patients with AD in Denmark. Clinic visits between 1994 and 2012 and hospital visits between 1977 and 2012 for treatment of AD were included in the study. In addition, monthly total topical corticosteroids (TCS) between1996 and 2002 and calcineurin inhibitors (TCI) prescriptions (2003 to 2012) filled by patients with AD were compiled. The researchers calculated monthly averages of temperature, atmospheric pressure, cloud cover, and hours of bright sunlight, and compared these variables with health care utilization end points for the period between 2000 and 2012 with linear regression models.

Between 2000 and 2012, the mean monthly total emergency department visits for AD was 6, mean hospitalizations was 32, and mean outpatient visits was 170. Moreover, there were 3811 TCS prescriptions and 2552 TCI prescriptions filled by patients with AD over this same time period.

Health care utilization in patients with AD was highest in the winter and spring. Outside temperature was the environmental variable with the strongest association with health care utilization. Per 1°C lower monthly temperature, there were 2 more AD clinic/hospital visits/hospitalizations observed (95% CI, 1-4), 18 more TCS prescriptions filled (95% CI, 9-26), and 53 more TCI prescriptions filled (95% CI, 36-70).

Environmental variables were highly related. Associations between AD health care utilization and hours of cloud cover were generally positive, whereas hours of bright sunlight were generally inversely associated with health care utilization.

The investigators concluded that AD health care utilization markers change significantly according to the season. A decline in temperature correlated well with health care utilization in patients with AD, although a causative role could not be determined with certainty. Their findings suggest that targeted escalation of treatment according to weather predictions and increasing preventive clinic visits by high-risk patients with AD over the winter months represent potential clinical applications of these findings.

Reference

Hamann CR, Andersen YMF, Engebretsen KA, et al. The effects of season and weather on healthcare utilization among patients with atopic dermatitis [published online April 28, 2018]. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.15023