Patient treatment needs in atopic dermatitis: A real-world cohort study.

BACKGROUND

Atopic dermatitis (AD) substantially affects quality of life, yet standardized severity measures may not capture patient-centred priorities, making systematic needs assessment essential for personalized care.

OBJECTIVES

This study aimed to systematically assess and rank treatment needs in adults with moderate to severe AD, identify patient subgroups with distinct need profiles and evaluate how well these needs were met after 2 years of specialized dermatological care.

METHODS

In this prospective observational study from the TREATgermany registry, 697 adults with moderate to severe AD completed the validated Patient Benefit Index (PBI) at baseline (T1) and at 2-year follow-up (T2), capturing treatment goal importance and achievement. Subgroup analyses were performed based on age, sex, educational status and age at AD onset. Associations between clinical measures and perceived benefit were analysed.

RESULTS

The most frequently prioritized treatment goals were being free of itching (97.8% high agreement), regaining control of the disease (95.3%) and relief from skin burning (92.0%). The importance of itch reduction was not correlated with baseline pruritus intensity, and perceived benefit was more closely linked to relative clinical improvement than to absolute disease severity. Beyond these shared priorities, treatment needs varied across subgroups: older patients valued treatment safety and reduced dependence on medical care, women emphasized psychosocial and appearance-related goals, individuals with lower educational status highlighted financial concerns and patients with adult-onset AD prioritized diagnostic certainty and disease control. After 2 years, 96.6% of patients reported meaningful treatment benefit. Patient-reported outcomes (POEM) were more strongly associated with perceived benefit than physician-assessed measures (oSCORAD, EASI).

CONCLUSION

Patient treatment needs in AD vary by demographic and clinical factors, with pruritus consistently rated as the highest priority. Patient-reported outcomes align more closely with perceived benefit than physician assessments, underscoring the value of systematic needs assessments to guide individualized treatment decisions and shared decision-making.