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A concept for integrated care pathways for atopic dermatitis-A GA2 LEN ADCARE initiative

Zuberbier T 1 , Abdul Latiff A 2 , Aggelidis X 3 , Augustin M 4 , Balan RG 5 , Bangert C 6 Show all authors , Beck L 7 , Bieber T 8 , Bernstein JA 9 , Bertolin Colilla M 10 , Berardi A 11 , Bedbrook A 12 , Bindslev-Jensen C 13 , Bousquet J 14 , de Bruin-Weller M 15 , Bruscky D 16 , Buyuktiryaki B 17 , Canonica GW 18 , Castro C 19 , Chanturidze N 20 , Chong-Neto HJ 14 , Chu CY 21 , Chularojanamontri L 22 , Cork M 23 , Criado RFJ 24 , Barredo LC 25 , Custovic A 26 , Darsow U 27 , Emurlai A 28 , de Pablo A 29 , Del Giacco S 30 , Girolomoni G 31 , Deleva Jovanova T 32 , Deleuran M 33 , Douladiris N 3 , Duarte B 34 , Dubakiene R 35 , Eller E 13 , Engel-Yeger B 36 , Ensina LF 37 , Filho NR 14 , Flohr C 38 , Fomina D 39 , Francuzik W 40 , Galimberti ML 41 , Giménez-Arnau AM 42 , Godse K 43 , Mortz CG 13 , Gotua M 20 , Hide M 44 , Hoetzenecker W 45 , Hunzelmann N 46 , Irvine A 47 , Jack C 48 , Kanavarou I 3 , Katoh N 49 , Kinaciyan T 6 , Kocatürk E 17 , Kulthanan K 22 , Lapeere H 50 , Lau S 51 , Machado Forti Nastri M 52 , Makris M 3 , Mansour E 53 , Marsland A 54 , Morelo Rocha Felix M 55 , Moschione Castro AP 56 , Nettis E 57 , Nicolas JF 58 , Nosbaum A 59 , Odemyr M 60 , Papapostolou N 3 , Parisi CAS 42 , Paudel S 61 , Peter J 62 , Pokharel P 63 , Puig L 64 , Quint T 6 , Ramon GD 63 , Regateiro F 65 , Ricci G 66 , Rosario C 67 , Sackesen C 17 , Schmid-Grendelmeier P 68 , Serra-Baldrich E 69 , Siemens K 70 , Smith C 71 , Staubach P 72 , Stevanovic K 1 , Su-Kücük Ö 73 , Sussman G 74 , Tavecchio S 75 , Teovska Mitrevska N 76 , Thaci D 77 , Toubi E 78 , Traidl-Hoffmann C 79 , Treudler R 80 , Vadasz Z 81 , van Hofman I 82 , Ventura MT 83 , Wang Z 84 , Werfel T 85 , Wollenberg A 86 , Yang A 87 , Weng Yew Y 88 , Zhao Z 89 , Zwiener R 90 , Worm M 4

Affiliations 

  • 1 Institute of Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
  • 2 Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
  • 3 Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, University General Hospital "Attikon", Athens, Greece
  • 4 University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  • 5 Institutul Regional de Gastroenterologie si Hepatologie, Cluj-Napoca, Romania
  • 6 Department of Dermatology, Medical University of Vienna, Vienna, Austria
  • 7 University of Rochester Medical Center, Rochester, New York, USA
  • 8 University Hospital of Bonn, Bonn, Germany
  • 9 University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
  • 10 Hospital del Mar, Barcelona, Spain
  • 11 Instituto de Asma, Alergia y Enfermedades Respiratorias, Corrientes, Argentina
  • 12 MACVIA-France, Fondation Partenariale FMC VIA-LR, Montpellier, France
  • 13 Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense C, Denmark
  • 14 Division of Allergy and Immunology, Complexo Hospital de Clinicas Federal University of Paraná, Curitiba, Brazil
  • 15 Department of Dermatology/Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht, Utrecht, The Netherlands
  • 16 Federal University of Pernambuco, Recife, Brazil
  • 17 Division of Pediatric Allergy, Koc University Hospital, Istanbul, Turkey
  • 18 Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
  • 19 Department of Dermatology, Hospital Universitario Austral, Universidad Austral, Buenos Aires, Argentina
  • 20 Center of Allergy and Immunology, Tbilisi, Georgia
  • 21 Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan
  • 22 Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 23 Sheffield Dermatology Research, IICD, University of Sheffield, Sheffield, UK
  • 24 Alergoskin Alergia e Dermatologia, Santo Andre, Brazil
  • 25 Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
  • 26 National Heart and Lung Institute, Imperial College, London, UK
  • 27 Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany
  • 28 Clinical Hospital Tetovo, Tetovo, North Macedonia
  • 29 Hospital Universitario Austral, Pilar, Argentina
  • 30 Allergy and Clinical Immunology, University of Cagliari, Sardinia, Italy
  • 31 Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
  • 32 Health Center Skoplje, Skoplje, North Macedonia
  • 33 Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
  • 34 Hospital Santo Antonio dos Capuchos, Centro Universitário de Lisboa Central, Lisbon, Portugal
  • 35 Department of Immunology and Allergology, Medical Faculty, Clinics of Chest Diseases, Vilnius University, Vilnius, Lithuania
  • 36 Occupational Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
  • 37 CPAlpha Clinical Research Center, Barueri - São Paulo, Brazil
  • 38 St John's Institute of Dermatology, St Thomas' Hospital, London, UK
  • 39 Center of Allergy and Immunology, Clinical State Hospital 52, Moscow Ministry of Healthcare, Moscow, Russian Federation
  • 40 Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
  • 41 Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
  • 42 Dermatology Department, Hospital del Mar, IMIM, Universitat Autonoma y Universitat Pompeu Fabra, Barcelona, Spain
  • 43 D.Y. Patil University, Navi Mumbai, Maharashtra, India
  • 44 Department of Dermatology, Hiroshima University Hospital, Hiroshima, Japan
  • 45 Department of Dermatology, Kepler University Hospital, Linz, Austria
  • 46 Department of Dermatology, University of Cologne, Cologne, Germany
  • 47 Clinical Medicine, Trinity College Dublin, Dublin, Ireland
  • 48 Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
  • 49 Department of Dermatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
  • 50 Ghent University Hospital, Ghent, Belgium
  • 51 Charité-Universitätsmedizin Berlin, Berlin, Germany
  • 52 Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Universidade de São Paulo, São Paulo, Brazil
  • 53 Division of Allergy and Immunology, Department of Clinical Medicine, University of Campinas, Campinas, Brazil
  • 54 Salford Royal Foundation Trust - University of Manchester and Spire Manchester Hospital, Manchester, UK
  • 55 AlergoLife Clinici, Rio de Janeiro, Brazil
  • 56 Instituto da Criança, Rio de Janeiro, Brazil
  • 57 Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy
  • 58 Department of Clinical Immunology and Allergy, Lyon-Sud University Hospital, CIRI/INSERM U1111, Lyon, France
  • 59 Service d'Allergologie et Immunologie Clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
  • 60 EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
  • 61 Center Civil Service Hospital, Kathmandu, Nepal
  • 62 Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa
  • 63 Instituto de Alergia e Inmunologia del Sur, Bahia Blanca, Buenos Aires, Argentina
  • 64 Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
  • 65 Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
  • 66 Department of Medical and Surgical Sciences DIMEC, University of Bologna, Bologna, Italy
  • 67 Federal University of Parana, Curitiba, Brazil
  • 68 Department of Dermatology Allergy Unit, University Hospital of Zürich, Zürich, Switzerland
  • 69 Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR 5308, UCBL1, ENS de Lyon, Lyon, France
  • 70 King's College London, London, UK
  • 71 St John's Institute of Dermatology, Guys and St Thomas' NHS Trust, London, UK
  • 72 Department of Dermatology and Allergy, Hautklinik und Poliklinik der Universitätsmedizin, University Medical Center, Mainz, Germany
  • 73 Department of Dermatology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
  • 74 Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 75 Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
  • 76 ReMedika General Hospital, Skopje, North Macedonia
  • 77 Center for Comprehensive Inflammation Medicine, University of Lübeck, Lübeck, Germany
  • 78 Allergy and Clinical Immunology, Holy Family Hospital, Nazareth, Israel
  • 79 Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
  • 80 Universtiy Leipzig Medical Faculty, Leipziger Interdisziplinäres Centrum für Allergologie, Leipzig, Germany
  • 81 Bnai-Zion Medical Center, Haifa, Israel
  • 82 GA2LEN Network, Berlin, Germany
  • 83 University of Bari Aldo Moro, Bari, Italy
  • 84 Department of Dermatology, Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
  • 85 Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
  • 86 Department of Dermatology and Allergy, Ludwig-Maximilian-University, Munich, Germany
  • 87 Division of Allergy and Clinical Immunology of University of Sao Paulo, São Paulo, Brazil
  • 88 National Skin Centre, Singapore, Singapore
  • 89 Department of Dermatology, First Hospital Peking University, Beijing, China
  • 90 Medicina Interna y Alergología e Inmunología Clínica, Hospital Universitario Austral, Pilar, Argentina
Clin Transl Allergy, 2023 Sep;13(9):e12299.
PMID: 37746794 DOI: 10.1002/clt2.12299

Abstract

INTRODUCTION: The integrated care pathways for atopic dermatitis (AD-ICPs) aim to bridge the gap between existing AD treatment evidence-based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co-ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems.

METHODS: The GA2 LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD-ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL2 EN ADCARE centres.

RESULTS: The AD-ICPs outline the diagnostic procedures, possible co-morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD.

CONCLUSION: The AD-ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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