Methodology

This research followed a five-step approach

Conduct literature review

Carry out site visits

Documenting good practice

Review findings with AD experts

Finalise Global AD report

Conduct literature review

Why?

To understand what challenges and good practices in the care and management of AD and associated comorbidities have already been established through published evidence

How?

KPMG reviewed articles from peer-reviewed journals and internationally recognised guidelines (such as EADV) for evidence-based practice of AD care and management

Carry out site visits

Why?

To observe and understand how practitioners deliver good practice and overcome key challenges in AD care

How?

32 sites that deliver AD care around the world were visited by KPMG. At each visit we conducted semi-structured interviews, a site tour, and open question interviews with core and extended AD team members to ensure that we developed a complete understanding of their activities

Documenting good practice

Why?

To document how care practitioners manage AD and develop a variety of good practice interventions

How?

Each visit was documented in a centre-specific report (available in the report appendix) which summarized the center’s approach to AD care and identified case studies of good practice. The reports were shared with and verified by each centre

Review findings with AD experts

Why?

To ensure that our findings capture the key challenges and gaps faced in the delivery of AD care and to work together to define the good practice interventions that can help to overcome these challenges globally

How?

Case studies were presented at steering group meetings in order to define good practice interventions, discuss the global applicability of the interventions and how they might be made relevant to all AD centres

Finalise Global AD report

Why?

To present all findings in one comprehensive report that can be used by any AD centre to improve their management of AD and its associated comorbidities

How?

We summarised our findings and created a Global AD report which identifies common themes and challenges in the management of AD and associated co-morbidities as well as outlining interventions and case studies of good practice

An initial literature review identified existing global challenges and good practice in AD care

We comprehensively reviewed guidelines and publications across AD diagnosis, treatment, management of comorbidities and patient outcomes

KPMG reviewed academic and clinical publications in addition to high-quality grey literature from a number of reputable sources

Major international recommendations and guidelines for all indications in the scope of this report were also reviewed, including Journal of the American Academy of Dermatology, Journal of the European Academy of Dermatology and Venereology, American Journal of Clinical Dermatology, British Journal of Dermatology, JAMA Dermatology and local recommendations/guidelines

KPMG consulted numerous publications by national governments and private institutions detailing healthcare good practices and future plans

Our literature review formed the basis of our site visit investigation. It helped us form a comprehensive view of the AD care and management landscape, with initial findings providing an insight into where there are potential improvements to be made

Site visits were conducted to identify current and practical good practice initiatives

Following a detailed and rigourous process, we selected 32 centres

Following a detailed process, we selected 32 centres of different type, size, location and have various funding models and AD initiatives in place

Working with the core and extended AD care team

In total, KPMG conducted 250+ interviews with a wide range of stakeholders at the selected sites, with each interview lasting ~20 mins to 1 hour

Who did we speak to?

AD

  • Dermatologists

  • Medical assistants

  • Paediatricians

  • Dermatology nurses

Co-morbidity specialists

  • Pulmonologists

  • Allergists

  • Ophthalmologists

  • Occupational therapists

  • Immunologists

Other healthcare professionals involved

  • Service coordinators

  • Psychologists

  • Patient Advocacy Group (PAG) representatives

  • Pharmacists

  • Nutritionists

  • Laboratory technicians

  • Researchers

  • Therapists

What did we ask them?

Interview questions were targeted to identify challenges in care and how interventions are used to overcome this:

  • Awareness of condition

  • Screening

  • Diagnosis

  • Referral pathway from PCP to HCP

  • Medical and non-medical management (including any innovative approaches adopted by the centre)

  • Access to multidisciplinary care

  • Clinical management

  • Follow-up care

  • Training of medical staff

Overview of key themes

Overview of centre

  • Number of patients, services, demographics, funding

Measurement

  • How and when KPIs and outcomes are captured

Challenges in AD and comorbidity care

Interventions

  • What it is and what challenge does it overcome

  • What are the outcomes for patients and healthcare systems

Implementation

  • Who/what is involved

  • How is it implemented

In order to document examples of AD care, we visited 32 centres from across the globe

Contributors verified and prioritised our key findings and interventions from the site visits

Centre review of findings

Identification of good practice interventions

Steering Committees

>Centre review of findings

  • Following each centre visit, KPMG documented the findings in a centre-specific report identifying specifically:
    • Key challenges faced
    • ‘Good practice’ interventions
    • Measurement of outcomes from interventions
  • The report was shared with the centre for review and approval (to validate the findings)

Identification of good practice interventions

  • The case studies were presented and discussed with a steering committee
  • This collaboration enabled the identification of an expert-reviewed set of globally relevant interventions capable of effectively assisting in the management of AD and its comorbidities

Steering Committees

  • Four dermatologists formed the main steering group to help shape and define the global good practice interventions

We created a comprehensive report to help centres to improve AD patient care

The interactive report documents challenges, good practice interventions and case studies from centres across the globe

Challenges in managing AD and its comorbidities

  • With the guidance of the Steering Committee and supported by our literature review, the report identified a series of gaps and challenges faced in the care of AD
  • These challenges were categorised by where they manifest along the patient pathway and if they impact the patient, HCP or healthcare system

Identification of good practice interventions

  • The experts identified 10 distinct interventions of good practice AD and comorbidity care management across the patient pathway
  • The interventions were collated from across the centres visited and shaped by dermatologists
  • These were prioritised according to how much of a positive impact they can have on care outcomes in proportion to the resources required for implementation

Case studies from AD centres visited


  • For each of the interventions identified, all relevant case studies were collated to demonstrate the variety of methods that the intervention can be implemented
  • All case studies were described at length in the specific centre report, in order to help illuminate for other centres some of the practical steps taken to implement the intervention and provide some more detail on the key challenges/benefits experienced by the centre and its patients