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Patients' perceptions of the usefulness and outcome of patch testing

https://doi.org/10.1016/j.jaad.2006.11.034Get rights and content

Background

Studies have shown the effect of allergic contact dermatitis on quality of life, but few address the impact of patch testing.

Objective

We sought to determine patient satisfaction with patch testing, patients' perceptions of its usefulness, dermatitis outcomes, and recall of allergens.

Methods

After patch testing, surveys were mailed to 1453 patients.

Results

Response rate was 52.1%, 757 surveys returned: 518 women (68.4%) and 239 men (31.6%). More than 75% (578) of respondents were at least “somewhat satisfied” with the process; 51% (388) were “very satisfied.” More than half (430, 58.3%) reported improved dermatitis. The 580 patients who had positive reactions remembered a mean of 51.0% of allergens; 198 of these (34.1%) remembered 100%. Of 2547 positive reactions to allergens, 1229 (48.3%) were remembered correctly.

Limitations

Limitations were reporting bias and individual interpretations of questions.

Conclusion

Although patients reported both satisfaction with patch testing and improvement in skin conditions, they forgot more than 40% of identified allergens. Techniques are needed to improve patient recall.

Section snippets

Methods

After the study was approved by our institutional review board, 1500 consecutive patients who had undergone patch testing at one of the Mayo Clinic sites (Jacksonville, Fla; Rochester, Minn; or Scottsdale, Ariz) were selected to receive a survey by mail. This group consisted of patients who had been tested to the standard series between December 16, 2002, and September 30, 2004. A total of 47 patients were excluded because they were pediatric patients, were deceased, or had refused research

Results

Of the 1453 surveys sent, 757 were returned (response rate 52.1%); 621 were never returned; 64 refused the Health Insurance Portability and Accountability Act form; and 11 either did not think the survey applied to them or filled out the survey but failed to sign the Health Insurance Portability and Accountability Act form. The mean time between patch testing and survey completion was 13.4 ± 6.5 months. Mean age at the time of the survey was 59.5 ± 16.0 years (range: 18.6-94.1 years); 518

Discussion

In this study, we found that patients were, in general, satisfied with the patch-testing process, that their skin improved after patch testing, and that they could recall more than 50% of allergens identified during the patch-testing process.

It was interesting that patients were so satisfied with the process of patch testing, because it is a time-consuming (5 days) and labor-intensive process. We were pleased that more than three fourths of the patients who responded to our survey were at least

Limitations

Our study had limitations as seen with any survey, such as reporting bias; patients who are very pleased or very angry may be more likely to respond. In addition, patients may interpret the questions in many ways. However, our survey is strengthened by the large number of respondents (757 patients, 52%), all of who had had a uniform experience of patch testing during a defined time period (almost 2 years). A further limitation of this study was that it was not pretested. It also did not address

Conclusion

Our study supports previous reports that patch testing is perceived by patients as a valuable tool that positively affects their dermatitis. However, this study also illustrates that many identified allergens are forgotten by patients after patch testing.

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Funding sources: None.

Conflicts of interest: None declared.

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