Who Sees you Matters: A Population Study Examining Topical Corticosteroid Prescribing Patterns between Primary Care Providers and Dermatologists for Atopic Dermatitis.

Background: Many patients with atopic dermatitis seek care from both primary care physicians and dermatologists. However, little is known regarding topical corticosteroid prescribing patterns among these specialties.Objective: We sought to determine if differences exist in topical corticosteroid prescribing patterns among dermatologists, family medicine physicians, and internal medicine physicians.Methods: We conducted a population-based, cross-sectional analysis using data from the U.S. National Ambulatory Medical Care Survey from 2006 to 2016.Results: Compared to dermatologists, internal medicine physicians were 22 times less likely to prescribe a topical corticosteroid for atopic dermatitis (52.2% versus 5.1%, p = 0.001; adjusted OR 0.045, 95% CI 0.007- 0.277). There was not a statistically significant difference in the rate of topical corticosteroid prescriptions for atopic dermatitis between family medicine physicians and dermatologists (39.1% vs. 52.2%, p = 0.27; adjusted OR 0.468, 95% CI 0.174- 1.257). Family medicine physicians had a higher rate of prescribing topical corticosteroids for atopic dermatitis than internal medicine physicians (39.1% vs. 5.1%, p = 0.002).Limitations: Severity of atopic dermatitis was not assessed.Conclusions: Atopic dermatitis patients seen by internal medicine physicians are much less likely to receive topical corticosteroid prescriptions as compared to those seen by dermatologists.