Dr Colin R. Simpson and colleagues from the University of Edinburgh, the University of Manchester and the University of Nottingham carried out this study looking at eczema diagnosis and treatment at GP surgeries in England between 2001 and 2005. It was funded by the NHS Health and Social Care Information Centre and published in the peer-reviewed Journal of the Royal Society of Medicine.
(Simpson CR, Newton J, Hippisley-Cox J, Sheikh A. Trends in the epidemiology and prescribing of medication for eczema in England. JRSM 2009; 102: 108-117)
The study found a 42% overall increase in the rate of new eczema cases each year. In absolute terms, this was an increase from about 10 cases per 1,000 in 2001 to 14 cases per 1,000 in 2005 (four new cases per 1,000 people over five years).
The study also found an increase in age-sex standardised lifetime prevalence of eczema of 48.2%. This means that the number of people diagnosed with eczema at some point in their lives increased from 77.78 people in every 1,000 in 2001 to 115.26 in every 1,000 people in 2005. This signifies an increase of about 38 people with eczema in every 1,000 people between 2001 and 2005. The increases were found in most age groups and both genders.
On average, the eczema patients consulted a GP four times a year, and prescriptions for eczema medications increased by about 57%. An estimated total of 13,700,000 were prescriptions issued in 2005.
Broadly, the investigators attributed this rise to:
• A real increase in allergic disease.
• An increase in clinicians’ awareness of these conditions. In other words, the identification and recording of eczema has improved without an actual increase in the number of eczema cases.
• An increase in patient’s (or parents of patients) awareness of eczema. This would lead to increasing presentation of the condition to GPs and their prescribing of treatment.
Unfortunately, time trend studies such as this cannot pinpoint the reason behind the increase in cases of eczema. The researchers conclude that “whether these findings reflect a genuine increase in the incidence of eczema, improved awareness, diagnosis and recording in primary care, or, perhaps most plausibly, a combination of genuine increases and improved identification and recording, is a question with important public health implications”.
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