Ivan Cherrez-Ojeda, Karla Robles-Velasco, Ana Giménez, Kiran Godse, Dorota Krasowska, Joanna Bartosińska, Paulina Szczepanik-Kułak, Bartłomiej Wawrzycki, Pavel Kolkhir, Anastasiia Allenova, Andrey Allenov, Sergey Tkachenko, Natasa Teovska Mitrevska, D Mijakoski, Sasho Stoleski, Marta Kołacińska-Flont, Izabela Kuprys-Lipinska, Joanna Molińska, Alicja Kasperska-Zając, M Zajaç, Mateusz Zamlynski, Florin Mihaltan, Ruxandra Ulmeanu, Anna Zalewska-Janowska, Katarzyna Tomaszewska, Mona Al-Ahmad, Maryam Ali Al-Nesf, Tayseer Ibrahim, Sami Agel, David Pesqué, Mónica Rodríguez-González, Guillermo Hideo Wakida-Kuzunoki, German D. Ramon, German D. Ramon, Sophia Neisinger, Hanna Bonnekoh, Maia Rukhadze, Maryam Khoshkhui, Mehraneh Movahedi Aliabadi, Daria Fomina, Désirée Larenas-Linnemann, Mitja Košnik, Rabia Oztas Kara, Chrystopherson Gengyny Caballero López, Q F Liu, Juan Carlos Ivancevich, Luis Felipe Ensina, Nelson Rosario, Violeta Kvedarienė, Moshe Ben-Shoshan, Roberta Fachini Jardim Criado, Andrea Bauer, Annia Chérrez, Herberto Chong-Neto, Maria Isabel Rojo-Guierrez, Michael Rudenko, José Ignacio Larco Sousa, Aleksandra Lesiak, E. T. Matos, Nelson Muñoz, Jaime Moreno, Ivan Tinoco, Marco Faytong-Haro, Jean Bousquet, Torsten Zuberbier
Background: LEN UCARE (Urticaria Centers of Reference and Excellence) and ADCARE (Angioedema Centers of Reference and Excellence) networks found that patient-reported outcome measures (PROMs) are underused in clinical practice for atopic dermatitis (AD) and chronic urticaria (CU). The reasons for this remain unknown. We studied why physicians have reservations about using PROMs, how PROM use is affected by the barriers they perceive, and what the physician demographics/characteristics associated with these barriers are. Methods: This is an observational, cross-sectional study where the PROMUSE questionnaire was used and applied to physicians from 45 specialized centers worldwide. Of the 2534 physicians surveyed in the PROMUSE study, 474 who treated patients with AD and CU were included in the analysis. Results: For the 474 physicians who treat AD and CU patients, the most common issues perceived as primary barriers to PROM use were "time constraints" (n = 455/474), "not mandated to complete" (n = 428/474), and "patients dislike PROMs" (n = 425/474). Higher rates of barrier perception were observed for males, younger physicians, and non-specialist physicians. The more barriers physicians perceive, the less frequently PROMs are used, with a strong and significant negative correlation between the number of barriers perceived and the frequency of PROM use. Two of the 15 perceived barriers significantly prevented using PROMs: the belief that PROMs constrain the doctor-patient relationship and the belief that patients dislike them. Conclusions: The underutilization of PROMs in AD and CU is strongly driven by physicians' perceptions that patients dislike them and that they constrain the doctor-patient relationship. This suggests physicians may have deeper insights into the practical shortcomings of current instruments. Therefore, rather than solely focusing on physician education, existing AD and CU PROMs urgently require re-evaluation and co-development with direct patient involvement (eg, Core Outcome Sets) to ensure they are genuinely patient-centered and clinically relevant.