P3.P316: Understanding Healthcare Disparities & Health Equity in Atopic Dermatitis Patients: Building Knowledge, Confidence and Change in Primary Care Providers Learning Collaborative

Purpose/Objectives: Atopic dermatitis (AD) affects an estimated 13% of children in the United States, and it is one of the most common skin conditions diagnosed in this population. Moreover, AD is more prevalent in Black patients and tends to be more severe and persistent in individuals with skin of color. Therefore, this Quality Improvement (QI) project’s purpose was to increase knowledge, confidence, and competence of pediatric healthcare providers in recognizing and discussing symptoms of AD, treatment options, and its overall management, especially in patients with skin of color and diverse cultural and socio-economic backgrounds. This included managing symptoms and medications for patients with AD and making appropriate referrals to dermatology specialists.

Design/Methods: The program implemented evidence-based QI measures designed to address the system of care in managing AD, including physical, social, and quality of life of patients. The QI curriculum was designed to support primary care providers with specific anticipatory guidance, diagnosis, and treatment strategies around the most common symptoms and comorbidities of AD.

The program utilized a multi-pronged approach, including gathering background information, caregiver focus group review of existing resources, new resource development, and QI practice facilitation aimed at practical healthcare provider behavior change. Resources for patients, caregivers, and healthcare professionals were created and provided to participating practices. Provider confidence in two management domains was measured pre- and post-program: discussing AD with patients/caregivers and treatment of AD.

Results: From January to October 2023, a total of 938 AD patients were screened in 10 practices. An increase of screening rates from 64% to 99% was observed, with an average of 77.4% of patients being from a diverse population. At baseline, 0% of providers (n=25) were providing AD education materials, which increased to 95% after the program. Provider confidence in treating and discussing AD with patients/caregivers increased to 100%. Providers who were very confident increased from 8% to 62.5%. Additionally, the remaining providers (37.5%) reported being confident.

Conclusion/Discussion: The QI project increased knowledge and confidence of primary care providers in the management of AD in pediatric patients. In hopes of making a positive impact on the overall care of pediatric patients with AD, especially in patients with skin of color and diverse backgrounds, the AD QI program created systemic practice changes which were successful in training providers to recognize symptoms of AD, to establish appropriate treatment plans, and in discussing quality of life.

Barriers included limited recruitment of patients, providers, and staff, limited time for providers to complete screenings, and limited provider knowledge of billing opportunities for additional AD services completed. Next steps include follow up with providers in 6 months to measure how practices are continuing to utilize the AD Plan of Care, materials, and diagnostic screenings.