RESEARCH LETTER
Bruno HALIOUA1, Charles TAIEB1,2*, Stéphanie MERHAND3 and Delphine STAUMONT-SALLE4
1Société Française des Sciences Humaines de la Peau, Maison de la dermatologie, Paris, France, 2European Market Maintenance Assessment, Patients Priority, Paris, France, 3Association Française de l'Eczema, Redon, France, and 4CHU Lille, Service de Dermatologie, Univ Lille, INSERM U1286, Lille Inflammation Translational Research Institute (INFINITE), Lille, France. *Email: charles.taieb@emma.clinic
Citation: Acta Derm Venereol 2025; 105: adv-2025-0096. DOI: https://doi.org/10.2340/actadv.v105.adv-2025-0096.
Copyright: © 2025 The Author(s). Published by MJS Publishing, on behalf of the Society for Publication of Acta Dermato-Venereologica. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/).
Submitted: Oct 11, 2025. Accepted after revision: Oct 21, 2025.
Published: Dec 22, 2025.
Competing interests and funding: This study was granted by Abbvie, Almirall, Eucerin & Sanofi.
The data that support the findings of this work are available from the corresponding author upon reasonable request.
In accordance with law n°2012–300 of 5 March 2012 relating to research involving the human person, this research has obtained the favourable opinion of the Comité de Protection des Personnes Est III 2024-A00533-44.
To the Editor
Patient satisfaction is now an essential indicator for assessing the quality of care. It is not limited to the disappearance of symptoms but encompasses the patient’s entire experience: their relationship with healthcare professionals, the clarity of the information received, the consideration given to their expectations and the psychological support provided. In dermatology, and particularly in atopic dermatitis (AD), this concept is crucial, as the disease is chronic and has a significant impact on quality of life (1).
As part of its atopy barometer (2, 3), the French Eczema Association conducted an observational study of 1,201 patients with AD (758 women and 443 men). The median age of the sample was 44 years. The data included sociodemographic and clinical variables, the atopic dermatitis burden score (ABS-A) (4) to measure the burden of the disease, and questions targeting the physician–patient relationship and therapeutic expectations. Associations with satisfaction were assessed using multivariate analyses (logistic regression).
In our sample, patients with mild AD and those with moderate-to-severe disease showed overall similar clinical profiles according to the patient-oriented eczema measure (POEM) score, although some differences were observed. Moderate-to-severe forms were associated with younger age and a significantly higher disease burden (ABS-A: 25.7 vs 23.4, p=0.01). The proportion of patients considering their treatment appropriate was comparable between groups (≈83%), but overall satisfaction with care was lower among patients with moderate-to-severe disease (46.3 vs 57.2, p<0.001). These patients more frequently reported being involved in treatment decisions and perceived that their well-being was taken into account by their physician. However, regardless of disease severity, fewer than half of the patients reported having discussed all available treatment options, and only about half indicated that potential adverse effects had been addressed. Notably, only 10% of patients who are not on systemic treatments are aware of a superior therapeutic option. It should be noted that only 33% stated that their physician asked about their expectations and the outcomes they wished to achieve with their treatment (Table I).
Table I. Clinical characteristics and physician–patient relationship by sex
| Variable | Atopic dermatitis rated mild by POEM N=804 |
Atopic dermatitis rated moderate/severe by POEM N=397 |
p-value |
|---|---|---|---|
| Age | 45.98 (±15.35) Range: (18; 81.) |
40.66 (±14.26) Range: (18; 81.) |
<0.001 |
| Man | 297 (36.94%) | 146 (36.78%) | >0.999 |
| Woman | 507 (63.06%) | 251 (63.22%) | |
| ABS-A | 23.4 (±19.04) Range: (0.0; 90.0) |
25.76 (±18.74) Range: (0.0; 90.0) |
0.013 |
| State that their treatment is suitable for them | 671 (83.46%) | 331 (83.38%) | >0.999 |
| Say they are satisfied with their care | 460 (57.21%) | 184 (46.35%) | <0.001 |
| Their physician asked them about their expectations | 269 (33.46%) | 135 (34.01%) | 0.901 |
| Say they felt involved in the choice of treatment | 378 (47.01%) | 214 (53.9%) | 0.029 |
| Their physician explained the expected results of the new treatment | 402 (50.0%) | 198 (49.87%) | >0.999 |
| They had the opportunity to discuss the different treatment options available for their atopic eczema, including no treatment | 350 (43.53%) | 175 (44.08%) | 0.906 |
| State that their physician asked them about their expectations | 269 (33.46%) | 135 (34.01%) | 0.901 |
| Believe that their physician takes their well-being into account in each treatment option | 378 (47.01%) | 214 (53.9%) | 0.029 |
| Their physician mentioned possible tolerance issues. | 425 (52.86%) | 213 (53.65%) | 0.844 |
| Their physician mentioned treatment alternatives to them | 350 (43.53%) | 175 (44.08%) | 0.906 |
| ABS-A:Atopic dermatitis Burden Score -Adult; POEM:Patient-Oriented Eczema Measure. | |||
Multivariate analysis identified distinct factors associated with satisfaction depending on AD severity. In patients with mild forms, satisfaction was strongly associated with the perception that their treatment was appropriate (odds ratio [OR]=4.3 [2.74; 6.74], p<0.0001), that side effects had been discussed (OR=2.19 [1.49; 3.23], p<0.0001) and that the physician took their well-being into account in treatment decisions (OR=1.6 [1.09; 2.34], p=0.0164). Among those with moderate-to-severe AD, satisfaction was more strongly linked to having a treatment deemed appropriate (OR=2.35 [1.22; 4.52], p=0.0107), being asked about their expectations (OR=2.00 [1.17; 3.4], p=0.0107) and having had tolerance issues addressed (OR=2.00 [1.18; 3.4], p=0.0104) (Table II).
Table II. Factors associated with patient satisfaction
| Atopic dermatitis rated moderate/severe by POEM | Atopic dermatitis rated mild by POEM | |||
|---|---|---|---|---|
| Odds ratio | p-value | Odds ratio | p-value | |
| Gender/Reference: Women | ||||
| 0.855 [0.545; 1.34] | 0.496 | Men | 1.03 [0.749; 1.42] | 0.846 |
| 2.29 [1.44; 3.66] | <0.0001 | ABS-A<24.0 | 1.64 [1.18; 2.29] | 0.003 |
| Age | ||||
| Reference: [35, 55] | ||||
| 0.432 [0.266; 0.701] | <0.0001 | [17, 35] | 0.861 [0.59; 1.26] | 0.441 |
| 0.83 [0.451; 1.53] | 0.548 | [55, 81] | 0.791 [0.547; 1.15] | 0.215 |
| 2.35 [1.22; 4.52] | 0.010 | State that their treatment is suitable for them | 4.3 [2.74; 6.74] | <0.001 |
| 1.12 [0.658; 1.92] | 0.669 | Their physician explained the expected results of the new treatment | 1.19 [0.81; 1.74] | 0.377 |
| 0.97 [0.575; 1.64] | 0.91 | They had the opportunity to discuss the different treatment options available for their atopic eczema, including no treatment | 0.743 [0.499; 1.11] | 0.144 |
| 2 [1.17; 3.4] | 0.010 | State that their physician asked them about their expectations | 1.02 [0.678; 1.53] | 0.927 |
| 0.791 [0.469; 1.33] | 0.379 | Say they felt involved in the choice of treatment | 1.36 [0.937; 1.98] | 0.105 |
| 0.943 [0.531; 1.67] | 0.841 | Believe that their physician takes their well-being into account in each treatment option | 1.6 [1.09; 2.34] | 0.0164 |
| 2 [1.18; 3.4] | 0.010 | Their physician mentioned possible tolerance issues. | 2.19 [1.49; 3.23] | <0.001 |
| ABS-A:Atopic dermatitis Burden Score -Adult; POEM:Patient-Oriented Eczema Measure. | ||||
These results confirm that satisfaction is not solely dependent on clinical outcomes but is deeply influenced by the quality of communication and the level of involvement patients have in their care (5). Despite the majority of patients judging their treatment to be suitable, only around half reported being satisfied with their overall management. This discrepancy underscores the importance of discussing product tolerance, addressing patient expectations and fostering shared decision-making to improve both satisfaction and adherence (6).