Key clinical point: Upadacitinib resulted in a good survival rate and was effective in patients with moderate to severe atopic dermatitis (AD) after over a year of continuous treatment, with no single characteristic of the study population being significantly associated with drug discontinuation.

Major finding: The drug survival rates at 1 and 1.5 years were 91.5% and 80.2%, respectively. The main reasons for discontinuation, occurring in 7.7% of patients, were adverse effects and ineffectiveness. However, no specific patient characteristics, such as sex or age at AD onset, showed a significant association with drug discontinuation.

Study details: This real-world retrospective study included 325 adult patients with moderate to severe AD who were treated with upadacitinib for at least 4 weeks and up to 72 weeks.

Disclosures: This study did not receive any external funding. The authors declared no conflicts of interest.

Source: Pezzolo E, Ortoncelli M, Ferrucci SM, et al. Drug survival of upadacitinib and predicting factors of discontinuation in adult patients affected by moderate-to-severe atopic dermatitis: An Italian multicenter analysis. J Clin Med. 2024;13:553 (Jan 18). doi: 10.3390/jcm13020553 Source

Key clinical point: Upadacitinib resulted in a good survival rate and was effective in patients with moderate to severe atopic dermatitis (AD) after over a year of continuous treatment, with no single characteristic of the study population being significantly associated with drug discontinuation.

Major finding: The drug survival rates at 1 and 1.5 years were 91.5% and 80.2%, respectively. The main reasons for discontinuation, occurring in 7.7% of patients, were adverse effects and ineffectiveness. However, no specific patient characteristics, such as sex or age at AD onset, showed a significant association with drug discontinuation.

Study details: This real-world retrospective study included 325 adult patients with moderate to severe AD who were treated with upadacitinib for at least 4 weeks and up to 72 weeks.

Disclosures: This study did not receive any external funding. The authors declared no conflicts of interest.

Source: Pezzolo E, Ortoncelli M, Ferrucci SM, et al. Drug survival of upadacitinib and predicting factors of discontinuation in adult patients affected by moderate-to-severe atopic dermatitis: An Italian multicenter analysis. J Clin Med. 2024;13:553 (Jan 18). doi: 10.3390/jcm13020553 Source

Key clinical point: Upadacitinib resulted in a good survival rate and was effective in patients with moderate to severe atopic dermatitis (AD) after over a year of continuous treatment, with no single characteristic of the study population being significantly associated with drug discontinuation.

Major finding: The drug survival rates at 1 and 1.5 years were 91.5% and 80.2%, respectively. The main reasons for discontinuation, occurring in 7.7% of patients, were adverse effects and ineffectiveness. However, no specific patient characteristics, such as sex or age at AD onset, showed a significant association with drug discontinuation.

Study details: This real-world retrospective study included 325 adult patients with moderate to severe AD who were treated with upadacitinib for at least 4 weeks and up to 72 weeks.

Disclosures: This study did not receive any external funding. The authors declared no conflicts of interest.

Source: Pezzolo E, Ortoncelli M, Ferrucci SM, et al. Drug survival of upadacitinib and predicting factors of discontinuation in adult patients affected by moderate-to-severe atopic dermatitis: An Italian multicenter analysis. J Clin Med. 2024;13:553 (Jan 18). doi: 10.3390/jcm13020553 Source

Key clinical point: In infants and young children with atopic dermatitis (AD), dupilumab treatment with concomitant low-potency topical corticosteroids (TCS) does not increase infection rates and is associated with a reduced risk for bacterial and non-herpetic skin infections.

Major finding: Patients receiving dupilumab vs placebo had similar total infection rates week 16 (rate ratio [RR] 0.75; P = .223) and a significantly lower frequency of non-herpetic skin infections (RR 0.46; P = .047) and bacterial infections (RR 0.09; P = .019).

Study details: This post hoc analysis of the phase 3 LIBERTY AD PRESCHOOL trial included 162 patients (age 6 months to 5 years) with moderate to severe AD who were randomly assigned to receive 200 or 300 mg dupilumab (n = 83) or placebo (n = 79) every 4 weeks with concomitant low-potency TCS.

Disclosures: This study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Four authors declared being employees or shareholders of Sanofi or Regeneron. The remaining authors declared having ties with Sanofi, Regeneron, or others.

Source: Paller AS, Siegfried EC, Cork MJ, et al. Infections in children aged 6 months to 5 years treated with dupilumab in a placebo-controlled clinical trial of moderate-to-severe atopic dermatitis. Paediatr Drugs. 2024 (Jan 24). doi: 10.1007/s40272-023-00611-9 Source

Key clinical point: In infants and young children with atopic dermatitis (AD), dupilumab treatment with concomitant low-potency topical corticosteroids (TCS) does not increase infection rates and is associated with a reduced risk for bacterial and non-herpetic skin infections.

Major finding: Patients receiving dupilumab vs placebo had similar total infection rates week 16 (rate ratio [RR] 0.75; P = .223) and a significantly lower frequency of non-herpetic skin infections (RR 0.46; P = .047) and bacterial infections (RR 0.09; P = .019).

Study details: This post hoc analysis of the phase 3 LIBERTY AD PRESCHOOL trial included 162 patients (age 6 months to 5 years) with moderate to severe AD who were randomly assigned to receive 200 or 300 mg dupilumab (n = 83) or placebo (n = 79) every 4 weeks with concomitant low-potency TCS.

Disclosures: This study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Four authors declared being employees or shareholders of Sanofi or Regeneron. The remaining authors declared having ties with Sanofi, Regeneron, or others.

Source: Paller AS, Siegfried EC, Cork MJ, et al. Infections in children aged 6 months to 5 years treated with dupilumab in a placebo-controlled clinical trial of moderate-to-severe atopic dermatitis. Paediatr Drugs. 2024 (Jan 24). doi: 10.1007/s40272-023-00611-9 Source

Key clinical point: In infants and young children with atopic dermatitis (AD), dupilumab treatment with concomitant low-potency topical corticosteroids (TCS) does not increase infection rates and is associated with a reduced risk for bacterial and non-herpetic skin infections.

Major finding: Patients receiving dupilumab vs placebo had similar total infection rates week 16 (rate ratio [RR] 0.75; P = .223) and a significantly lower frequency of non-herpetic skin infections (RR 0.46; P = .047) and bacterial infections (RR 0.09; P = .019).

Study details: This post hoc analysis of the phase 3 LIBERTY AD PRESCHOOL trial included 162 patients (age 6 months to 5 years) with moderate to severe AD who were randomly assigned to receive 200 or 300 mg dupilumab (n = 83) or placebo (n = 79) every 4 weeks with concomitant low-potency TCS.

Disclosures: This study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Four authors declared being employees or shareholders of Sanofi or Regeneron. The remaining authors declared having ties with Sanofi, Regeneron, or others.

Source: Paller AS, Siegfried EC, Cork MJ, et al. Infections in children aged 6 months to 5 years treated with dupilumab in a placebo-controlled clinical trial of moderate-to-severe atopic dermatitis. Paediatr Drugs. 2024 (Jan 24). doi: 10.1007/s40272-023-00611-9 Source

Key clinical point: Dose reduction of 300 mg dupilumab was successfully achieved by dose spacing to >2 weeks without loss of efficacy in most patients with persistently controlled atopic dermatitis (AD), regardless of previous exposure to biologics and Janus kinase inhibitors (JAKi).

Major finding: At a median follow-up of 10 months, dose spacing of 300 mg dupilumab without loss in efficacy was achieved in 35 of 37 patients with controlled AD receiving dupilumab treatment for a median duration of 20.1 months. Similar findings were observed in patients with vs without previous exposure to biologics or JAKi (P > .05).

Study details: Findings are from a retrospective cohort study including 37 patients with controlled AD for more than a year, who were treated with 300 mg dupilumab at intervals > 2 weeks, and of whom 7 patients were classified as non-naive to biologics and JAKi.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Lasheras-Pérez MA, Palacios-Diaz RD, González-Delgado VA, et al. Dose tapering of dupilumab in patients with persistently controlled atopic dermatitis: A Spanish multicenter cohort study. Int J Dermatol. 2024 (Jan 16). doi: 10.1111/ijd.17030  Source

Key clinical point: Dose reduction of 300 mg dupilumab was successfully achieved by dose spacing to >2 weeks without loss of efficacy in most patients with persistently controlled atopic dermatitis (AD), regardless of previous exposure to biologics and Janus kinase inhibitors (JAKi).

Major finding: At a median follow-up of 10 months, dose spacing of 300 mg dupilumab without loss in efficacy was achieved in 35 of 37 patients with controlled AD receiving dupilumab treatment for a median duration of 20.1 months. Similar findings were observed in patients with vs without previous exposure to biologics or JAKi (P > .05).

Study details: Findings are from a retrospective cohort study including 37 patients with controlled AD for more than a year, who were treated with 300 mg dupilumab at intervals > 2 weeks, and of whom 7 patients were classified as non-naive to biologics and JAKi.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Lasheras-Pérez MA, Palacios-Diaz RD, González-Delgado VA, et al. Dose tapering of dupilumab in patients with persistently controlled atopic dermatitis: A Spanish multicenter cohort study. Int J Dermatol. 2024 (Jan 16). doi: 10.1111/ijd.17030  Source

Key clinical point: Dose reduction of 300 mg dupilumab was successfully achieved by dose spacing to >2 weeks without loss of efficacy in most patients with persistently controlled atopic dermatitis (AD), regardless of previous exposure to biologics and Janus kinase inhibitors (JAKi).

Major finding: At a median follow-up of 10 months, dose spacing of 300 mg dupilumab without loss in efficacy was achieved in 35 of 37 patients with controlled AD receiving dupilumab treatment for a median duration of 20.1 months. Similar findings were observed in patients with vs without previous exposure to biologics or JAKi (P > .05).

Study details: Findings are from a retrospective cohort study including 37 patients with controlled AD for more than a year, who were treated with 300 mg dupilumab at intervals > 2 weeks, and of whom 7 patients were classified as non-naive to biologics and JAKi.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Lasheras-Pérez MA, Palacios-Diaz RD, González-Delgado VA, et al. Dose tapering of dupilumab in patients with persistently controlled atopic dermatitis: A Spanish multicenter cohort study. Int J Dermatol. 2024 (Jan 16). doi: 10.1111/ijd.17030  Source

Key clinical point: In real-world settings, dupilumab is safe and leads to significant and sustained improvements in the severity of atopic dermatitis (AD) in patients with moderate-to-severe AD, including those with malignancies and other comorbidities.

Major finding: At week 52, 64% of patients showed a decrease in disease severity, achieving a Physician Global Assessment score of 0 or 1 compared with a score of 3 or 4 at baseline. No adverse effect on current malignancy or recurrence of prior malignancy was reported with dupilumab use.

Study details: This real-world retrospective study analyzed the data of 155 adult patients with moderate-to-severe AD, including those with other significant comorbidities like malignancies, who were treated with dupilumab.

Disclosures: This study did not receive any funding. Mohannad Abu-Hilal declared serving as an advisor, consultant, or speaker for or receiving grants or honoraria from various sources.

Source: Metko D, Alkofide M, Abu-Hilal M. A real-world study of dupilumab in patients with atopic dermatitis including patients with malignancy and other medical comorbidities. JAAD Int. 2024;15:5-11 (Jan 15). doi: 10.1016/j.jdin.2024.01.002  Source

Key clinical point: In real-world settings, dupilumab is safe and leads to significant and sustained improvements in the severity of atopic dermatitis (AD) in patients with moderate-to-severe AD, including those with malignancies and other comorbidities.

Major finding: At week 52, 64% of patients showed a decrease in disease severity, achieving a Physician Global Assessment score of 0 or 1 compared with a score of 3 or 4 at baseline. No adverse effect on current malignancy or recurrence of prior malignancy was reported with dupilumab use.

Study details: This real-world retrospective study analyzed the data of 155 adult patients with moderate-to-severe AD, including those with other significant comorbidities like malignancies, who were treated with dupilumab.

Disclosures: This study did not receive any funding. Mohannad Abu-Hilal declared serving as an advisor, consultant, or speaker for or receiving grants or honoraria from various sources.

Source: Metko D, Alkofide M, Abu-Hilal M. A real-world study of dupilumab in patients with atopic dermatitis including patients with malignancy and other medical comorbidities. JAAD Int. 2024;15:5-11 (Jan 15). doi: 10.1016/j.jdin.2024.01.002  Source

Key clinical point: In real-world settings, dupilumab is safe and leads to significant and sustained improvements in the severity of atopic dermatitis (AD) in patients with moderate-to-severe AD, including those with malignancies and other comorbidities.

Major finding: At week 52, 64% of patients showed a decrease in disease severity, achieving a Physician Global Assessment score of 0 or 1 compared with a score of 3 or 4 at baseline. No adverse effect on current malignancy or recurrence of prior malignancy was reported with dupilumab use.

Study details: This real-world retrospective study analyzed the data of 155 adult patients with moderate-to-severe AD, including those with other significant comorbidities like malignancies, who were treated with dupilumab.

Disclosures: This study did not receive any funding. Mohannad Abu-Hilal declared serving as an advisor, consultant, or speaker for or receiving grants or honoraria from various sources.

Source: Metko D, Alkofide M, Abu-Hilal M. A real-world study of dupilumab in patients with atopic dermatitis including patients with malignancy and other medical comorbidities. JAAD Int. 2024;15:5-11 (Jan 15). doi: 10.1016/j.jdin.2024.01.002  Source

Key clinical point: Skin care by washing with water alone is not inferior to washing with a cleanser for the maintenance of remission in children with atopic dermatitis (AD) during the summer.

Major finding: The mean modified Eczema Area and Severity Index scores at 8 ± 4 weeks were similar in children who washed their upper and lower limbs with water and those who used a cleanser (0.00 and 0.15, respectively; P = .74). No difference was observed in the occurrence of skin infection, Patient-Oriented Eczema Measure, and other secondary outcomes with water vs cleanser use (all P > .05).

Study details: This noninferiority study included 43 children (age < 15 years) with AD having controlled eczema following regular steroid ointment application, who washed the randomly assigned left or right limb with a cleanser and the other limb with water alone.

Disclosures: This study was funded by the Maruho Scholarship Donations Support Program, Japan. Osamu Natsume declared receiving grants from several sources. The other authors declared no conflicts of interest.

Source: Katoh Y, Natsume O, Yasuoka R, et al. Skin care by washing with water is not inferior to washing with a cleanser in children with atopic dermatitis in remission in summer: WASH study. Allergol Int. 2024 (Feb 2). doi: 10.1016/j.alit.2024.01.007 Source

Key clinical point: Skin care by washing with water alone is not inferior to washing with a cleanser for the maintenance of remission in children with atopic dermatitis (AD) during the summer.

Major finding: The mean modified Eczema Area and Severity Index scores at 8 ± 4 weeks were similar in children who washed their upper and lower limbs with water and those who used a cleanser (0.00 and 0.15, respectively; P = .74). No difference was observed in the occurrence of skin infection, Patient-Oriented Eczema Measure, and other secondary outcomes with water vs cleanser use (all P > .05).

Study details: This noninferiority study included 43 children (age < 15 years) with AD having controlled eczema following regular steroid ointment application, who washed the randomly assigned left or right limb with a cleanser and the other limb with water alone.

Disclosures: This study was funded by the Maruho Scholarship Donations Support Program, Japan. Osamu Natsume declared receiving grants from several sources. The other authors declared no conflicts of interest.

Source: Katoh Y, Natsume O, Yasuoka R, et al. Skin care by washing with water is not inferior to washing with a cleanser in children with atopic dermatitis in remission in summer: WASH study. Allergol Int. 2024 (Feb 2). doi: 10.1016/j.alit.2024.01.007 Source

Key clinical point: Skin care by washing with water alone is not inferior to washing with a cleanser for the maintenance of remission in children with atopic dermatitis (AD) during the summer.

Major finding: The mean modified Eczema Area and Severity Index scores at 8 ± 4 weeks were similar in children who washed their upper and lower limbs with water and those who used a cleanser (0.00 and 0.15, respectively; P = .74). No difference was observed in the occurrence of skin infection, Patient-Oriented Eczema Measure, and other secondary outcomes with water vs cleanser use (all P > .05).

Study details: This noninferiority study included 43 children (age < 15 years) with AD having controlled eczema following regular steroid ointment application, who washed the randomly assigned left or right limb with a cleanser and the other limb with water alone.

Disclosures: This study was funded by the Maruho Scholarship Donations Support Program, Japan. Osamu Natsume declared receiving grants from several sources. The other authors declared no conflicts of interest.

Source: Katoh Y, Natsume O, Yasuoka R, et al. Skin care by washing with water is not inferior to washing with a cleanser in children with atopic dermatitis in remission in summer: WASH study. Allergol Int. 2024 (Feb 2). doi: 10.1016/j.alit.2024.01.007 Source

Key clinical point: A significant positive, dose-dependent association was observed between air quality index (AQI) and the incidence of atopic dermatitis (AD).

Major finding: The participants were classified into four AQI value quantiles (Q), with the mean AQI values from the lowest Q1 to the highest Q4 being 69.0, 78.9, 89.8, and 104.0, respectively. Compared with Q1, the risk for AD increased significantly in Q2 (adjusted hazard ratio [aHR] 1.29; 95% CI 1.04-1.65), Q3 (aHR 4.71; 95% CI 3.78-6.04), and Q4 (aHR 13.20; 95% CI 10.86-16.60). An increase of one unit in the AQI value increased the risk for AD by 7%.

Study details: This cohort study included 21,278,938 individuals without AD, with the long-term average AQI value before AD diagnosis being calculated and linked for each of the individuals.

Disclosures: This study was sponsored by grants from the Ministry of Science and Technology, Taiwan, Republic of China. The authors declared no conflicts of interest.

Source: Wu CY, Wu CY, Li MC, Ho HJ, Ao CK. Association of air quality index (AQI) with incidence of atopic dermatitis in Taiwan: A nationwide population-based cohort study. J Am Acad Dermatol. 2024 (Feb 1). doi: 10.1016/j.jaad.2024.01.058  Source

Key clinical point: A significant positive, dose-dependent association was observed between air quality index (AQI) and the incidence of atopic dermatitis (AD).

Major finding: The participants were classified into four AQI value quantiles (Q), with the mean AQI values from the lowest Q1 to the highest Q4 being 69.0, 78.9, 89.8, and 104.0, respectively. Compared with Q1, the risk for AD increased significantly in Q2 (adjusted hazard ratio [aHR] 1.29; 95% CI 1.04-1.65), Q3 (aHR 4.71; 95% CI 3.78-6.04), and Q4 (aHR 13.20; 95% CI 10.86-16.60). An increase of one unit in the AQI value increased the risk for AD by 7%.

Study details: This cohort study included 21,278,938 individuals without AD, with the long-term average AQI value before AD diagnosis being calculated and linked for each of the individuals.

Disclosures: This study was sponsored by grants from the Ministry of Science and Technology, Taiwan, Republic of China. The authors declared no conflicts of interest.

Source: Wu CY, Wu CY, Li MC, Ho HJ, Ao CK. Association of air quality index (AQI) with incidence of atopic dermatitis in Taiwan: A nationwide population-based cohort study. J Am Acad Dermatol. 2024 (Feb 1). doi: 10.1016/j.jaad.2024.01.058  Source

Key clinical point: A significant positive, dose-dependent association was observed between air quality index (AQI) and the incidence of atopic dermatitis (AD).

Major finding: The participants were classified into four AQI value quantiles (Q), with the mean AQI values from the lowest Q1 to the highest Q4 being 69.0, 78.9, 89.8, and 104.0, respectively. Compared with Q1, the risk for AD increased significantly in Q2 (adjusted hazard ratio [aHR] 1.29; 95% CI 1.04-1.65), Q3 (aHR 4.71; 95% CI 3.78-6.04), and Q4 (aHR 13.20; 95% CI 10.86-16.60). An increase of one unit in the AQI value increased the risk for AD by 7%.

Study details: This cohort study included 21,278,938 individuals without AD, with the long-term average AQI value before AD diagnosis being calculated and linked for each of the individuals.

Disclosures: This study was sponsored by grants from the Ministry of Science and Technology, Taiwan, Republic of China. The authors declared no conflicts of interest.

Source: Wu CY, Wu CY, Li MC, Ho HJ, Ao CK. Association of air quality index (AQI) with incidence of atopic dermatitis in Taiwan: A nationwide population-based cohort study. J Am Acad Dermatol. 2024 (Feb 1). doi: 10.1016/j.jaad.2024.01.058  Source

Key clinical point: Dupilumab monotherapy is safe and leads to rapid and significant improvements in disease signs and symptoms in patients with hand and foot (HF) atopic dermatitis (AD).

Major finding: At week 16, a significantly higher number of patients receiving dupilumab vs placebo achieved an HF Investigator’s Global Assessment score of 0 or 1 (P = .003) and ≥4-point reduction in HF Peak Pruritus Numeric Rating Scale score (P < .0001), with the difference between groups evident from weeks 4 and 1, respectively. Safety was consistent with the known dupilumab profile.

Study details: Findings are from the phase 3 LIBERTY-AD-HAFT study, which included 106 adults and 27 adolescents (≥ 12 to < 18 years) with moderate to severe HF AD who were randomized (1:1) to receive dupilumab or placebo.

Disclosures: This study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Ten authors declared being employees or shareholders of Sanofi or Regeneron. The remaining authors, except Ewa Sygula, declared serving as investigators, consultants, etc., for or receiving personal fees, grants, honoraria, etc., from Sanofi, Regeneron, or others.

Source: Simpson E, Silverberg JI, Worm M, et al. Dupilumab treatment improves signs, symptoms, quality of life and work productivity in patients with atopic hand and foot dermatitis: Results from a phase 3, randomized, double-blind, placebo-controlled trial. J Am Acad Dermatol. 2024 (Jan 29). doi: 10.1016/j.jaad.2023.12.066  Source

Key clinical point: Dupilumab monotherapy is safe and leads to rapid and significant improvements in disease signs and symptoms in patients with hand and foot (HF) atopic dermatitis (AD).

Major finding: At week 16, a significantly higher number of patients receiving dupilumab vs placebo achieved an HF Investigator’s Global Assessment score of 0 or 1 (P = .003) and ≥4-point reduction in HF Peak Pruritus Numeric Rating Scale score (P < .0001), with the difference between groups evident from weeks 4 and 1, respectively. Safety was consistent with the known dupilumab profile.

Study details: Findings are from the phase 3 LIBERTY-AD-HAFT study, which included 106 adults and 27 adolescents (≥ 12 to < 18 years) with moderate to severe HF AD who were randomized (1:1) to receive dupilumab or placebo.

Disclosures: This study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Ten authors declared being employees or shareholders of Sanofi or Regeneron. The remaining authors, except Ewa Sygula, declared serving as investigators, consultants, etc., for or receiving personal fees, grants, honoraria, etc., from Sanofi, Regeneron, or others.

Source: Simpson E, Silverberg JI, Worm M, et al. Dupilumab treatment improves signs, symptoms, quality of life and work productivity in patients with atopic hand and foot dermatitis: Results from a phase 3, randomized, double-blind, placebo-controlled trial. J Am Acad Dermatol. 2024 (Jan 29). doi: 10.1016/j.jaad.2023.12.066  Source

Key clinical point: Dupilumab monotherapy is safe and leads to rapid and significant improvements in disease signs and symptoms in patients with hand and foot (HF) atopic dermatitis (AD).

Major finding: At week 16, a significantly higher number of patients receiving dupilumab vs placebo achieved an HF Investigator’s Global Assessment score of 0 or 1 (P = .003) and ≥4-point reduction in HF Peak Pruritus Numeric Rating Scale score (P < .0001), with the difference between groups evident from weeks 4 and 1, respectively. Safety was consistent with the known dupilumab profile.

Study details: Findings are from the phase 3 LIBERTY-AD-HAFT study, which included 106 adults and 27 adolescents (≥ 12 to < 18 years) with moderate to severe HF AD who were randomized (1:1) to receive dupilumab or placebo.

Disclosures: This study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Ten authors declared being employees or shareholders of Sanofi or Regeneron. The remaining authors, except Ewa Sygula, declared serving as investigators, consultants, etc., for or receiving personal fees, grants, honoraria, etc., from Sanofi, Regeneron, or others.

Source: Simpson E, Silverberg JI, Worm M, et al. Dupilumab treatment improves signs, symptoms, quality of life and work productivity in patients with atopic hand and foot dermatitis: Results from a phase 3, randomized, double-blind, placebo-controlled trial. J Am Acad Dermatol. 2024 (Jan 29). doi: 10.1016/j.jaad.2023.12.066  Source

Key clinical point: A significant causal relationship was observed between atopic dermatitis (AD) and autoimmune diseases in children, and this was supported by the presence of shared genetic factors.

Major finding: At a follow-up of 12 years, children with vs without AD had a significantly increased risk for autoimmune diseases (adjusted hazard ratio [aHR] 1.27; 95% CI 1.23-1.32), particularly psoriasis vulgaris (aHR 2.55; 95% CI 2.25-2.80). Boys were significantly more susceptible to autoimmune diseases than girls (P for interaction = .04). Sixteen shared genes were identified between AD and autoimmune diseases and were associated with comorbidities, such as asthma and bronchiolitis.

Study details: This large-scale cohort study included 39,832 children with AD born between 2002 and 2018, who were matched with 159,328 children without AD.

Disclosures: This study was supported by the Korea Health Technology R&D. The authors declared no conflicts of interest.

Source: Ahn J, Shin S, Lee GC, et al. Unraveling the link between atopic dermatitis and autoimmune diseases in children: Insights from a large-scale cohort study with 15-year follow-up and shared gene ontology analysis. Allergol Int. 2024 (Jan 17). doi: 10.1016/j.alit.2023.12.005  Source

Key clinical point: A significant causal relationship was observed between atopic dermatitis (AD) and autoimmune diseases in children, and this was supported by the presence of shared genetic factors.

Major finding: At a follow-up of 12 years, children with vs without AD had a significantly increased risk for autoimmune diseases (adjusted hazard ratio [aHR] 1.27; 95% CI 1.23-1.32), particularly psoriasis vulgaris (aHR 2.55; 95% CI 2.25-2.80). Boys were significantly more susceptible to autoimmune diseases than girls (P for interaction = .04). Sixteen shared genes were identified between AD and autoimmune diseases and were associated with comorbidities, such as asthma and bronchiolitis.

Study details: This large-scale cohort study included 39,832 children with AD born between 2002 and 2018, who were matched with 159,328 children without AD.

Disclosures: This study was supported by the Korea Health Technology R&D. The authors declared no conflicts of interest.

Source: Ahn J, Shin S, Lee GC, et al. Unraveling the link between atopic dermatitis and autoimmune diseases in children: Insights from a large-scale cohort study with 15-year follow-up and shared gene ontology analysis. Allergol Int. 2024 (Jan 17). doi: 10.1016/j.alit.2023.12.005  Source

Key clinical point: A significant causal relationship was observed between atopic dermatitis (AD) and autoimmune diseases in children, and this was supported by the presence of shared genetic factors.

Major finding: At a follow-up of 12 years, children with vs without AD had a significantly increased risk for autoimmune diseases (adjusted hazard ratio [aHR] 1.27; 95% CI 1.23-1.32), particularly psoriasis vulgaris (aHR 2.55; 95% CI 2.25-2.80). Boys were significantly more susceptible to autoimmune diseases than girls (P for interaction = .04). Sixteen shared genes were identified between AD and autoimmune diseases and were associated with comorbidities, such as asthma and bronchiolitis.

Study details: This large-scale cohort study included 39,832 children with AD born between 2002 and 2018, who were matched with 159,328 children without AD.

Disclosures: This study was supported by the Korea Health Technology R&D. The authors declared no conflicts of interest.

Source: Ahn J, Shin S, Lee GC, et al. Unraveling the link between atopic dermatitis and autoimmune diseases in children: Insights from a large-scale cohort study with 15-year follow-up and shared gene ontology analysis. Allergol Int. 2024 (Jan 17). doi: 10.1016/j.alit.2023.12.005  Source

Eugene Yang, MD, often confronts the complexities of weighing various medical interventions for high blood pressure. Among these is when to scale back antihypertensive drugs or stop them completely.

He considers a patient’s comorbidities, severity of symptoms, and risk factors for heart attack and stroke, among other variables. Central to this calculus is the recognition of age as a pivotal determinant of quality of life, according to Dr. Yang, the chair of the Prevention of Cardiovascular Disease Council at the American College of Cardiology.

For older adults, for example, the variance in functional status can be striking. One octogenarian may be bedbound due to severe dementia, while another might be playing pickleball three times a week.

“This happens to me in my practice all the time. I have patients who are restricted in mobility and have severe memory loss: Their functionality is quite poor,” Dr. Yang said. “In a patient where we have a limited life expectancy, where they have limited function or core memory, the goal is not to prolong life: It’s to make them more comfortable.”

Knowing when to deprescribe blood pressure medications is crucial. For some, lifestyle changes can do the trick. For others, particularly older patients, their comorbid conditions and medication regimens need to be considered.

“There’s a recognition that we need to move to a new paradigm where we need to decide when to be aggressive and when to be less aggressive,” Dr. Yang said.

The American Heart Association and the American College of Cardiology most recently released guidelines in 2017, changing the cutoff for diagnosis from 140/90 to 130/80 mm Hg. The groups have issued no updates since then, leaving primary care physicians and their colleagues to navigate this territory with caution, balancing the benefits of reduction with the potential harms of undertreatment.

One example of an area that needs updating is the consideration of the age, currently missing from current guidance on hypertension management from government and medical bodies in the United States. However, European Society of Hypertension guidelines, updated in June 2023, recommend adults over age 80 or those classified as frail should be treated when their systolic blood pressure exceeds 160.

“For the first time, we have a chapter in the guidelines on hypertension and management in older people,” Reinhold Kreutz, MD, PhD, immediate past-president of the European Society of Hypertension, said. “If a patient has low blood pressure and symptoms such as dizziness or frailty, a reduction in medication should be considered.”

High blood pressure does not always present with noticeable symptoms, and patients do not always show up for an office visit in time for early intervention. It can pave the way for severe health complications including heart failure, stroke, kidney disease, heart attack, and, ultimately, death.

Grim statistics reveal its toll: Hypertension was a primary or contributing cause of nearly 700,000 deaths in the United States in 2021, and nearly half of adults have the condition. Only about one in four adults have their high blood pressure under control.
 

New Research Provides Insight

A recent study may provide needed insights for primary care clinicians: Gradually reducing hypertensive medication may not induce the feared fluctuations in blood pressure, contrary to prior concerns.

Researchers in Seoul, South Korea, analyzed the blood pressure of 83 patients diagnosed with hypertension who reduced their use of medication. They found that the use of less medication was associated with an increase in blood pressure readings taken at home but not in the clinic nor did it appear to influence blood pressure variability. The mean age of participants was 66 years.

Research shows systolic blood pressure variability is an important predictor of cardiovascular outcomes, as well as the risk for dementia.

When crafting treatment plans, clinicians should recognize the diverse factors at play for a particular patient, particularly concerning other health conditions.

Obesity, diabetes, and hyperlipidemia are among the common comorbidities often intertwined with hypertension. Because additional conditions come with more symptoms to consider and various medications, these health profiles demand tailored approaches to hypertension treatment.

Clinicians can recommend lifestyle modifications like dietary changes and regular exercise as first steps for patients who are diagnosed with grade 1 hypertension but who do not have cardiovascular disease, chronic kidney disease, diabetes, or organ damage. However, in cases where comorbidities are present or hypertension escalates to grade 2, clinicians should turn to medications for management, according to the International Society of Hypertension.

Patients with heart failure and reduced ejection fraction have unique challenges, according to Keith C. Ferdinand, MD, the Gereld S. Berenson Endowed Chair in Preventative Cardiology at the Tulane School of Medicine in New Orleans, Louisiana.

“Patients who have heart disease, they get a pump so the blood pressure comes down — but medicine is often needed to prevent further heart failure,” Dr. Ferdinand said.

Dr. Ferdinand stressed the importance of continuous medication to stave off further cardiac deterioration. He advocated for a cautious approach, emphasizing the continued use of medications like sacubitril/valsartan, beta-blockers, or sodium-glucose transport protein inhibitors to safeguard against heart failure progression.

Patients should also self-monitor blood pressure at home and be taught how to properly fit a cuff to enable accurate measurements. This approach empowers patients to actively engage in their health management and detect any deviations that warrant further attention, he said.
 

Medications for Hypertension

The use of any of the five major drug classes — angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium blockers, and thiazide/thiazide-like diuretics — and their combinations are recommended as the basis of antihypertensive treatment strategies.

Dr. Yang said primary care clinicians must be careful to decrease doses slowly. Central-acting medications such as clonidine and beta-blockers ultimately reduce heart rate and dilate blood vessels.

Decreasing the dose too quickly can create a rebound effect, and medication should be means reduced and closely monitored over the course of several weeks, Dr. Yang said.

“You cannot just withdraw abruptly with certain medications — you have to wean off slowly,” because patients may experience high blood pressure again, Dr. Yang said.

A version of this article appeared on Medscape.com.

Eugene Yang, MD, often confronts the complexities of weighing various medical interventions for high blood pressure. Among these is when to scale back antihypertensive drugs or stop them completely.

He considers a patient’s comorbidities, severity of symptoms, and risk factors for heart attack and stroke, among other variables. Central to this calculus is the recognition of age as a pivotal determinant of quality of life, according to Dr. Yang, the chair of the Prevention of Cardiovascular Disease Council at the American College of Cardiology.

For older adults, for example, the variance in functional status can be striking. One octogenarian may be bedbound due to severe dementia, while another might be playing pickleball three times a week.

“This happens to me in my practice all the time. I have patients who are restricted in mobility and have severe memory loss: Their functionality is quite poor,” Dr. Yang said. “In a patient where we have a limited life expectancy, where they have limited function or core memory, the goal is not to prolong life: It’s to make them more comfortable.”

Knowing when to deprescribe blood pressure medications is crucial. For some, lifestyle changes can do the trick. For others, particularly older patients, their comorbid conditions and medication regimens need to be considered.

“There’s a recognition that we need to move to a new paradigm where we need to decide when to be aggressive and when to be less aggressive,” Dr. Yang said.

The American Heart Association and the American College of Cardiology most recently released guidelines in 2017, changing the cutoff for diagnosis from 140/90 to 130/80 mm Hg. The groups have issued no updates since then, leaving primary care physicians and their colleagues to navigate this territory with caution, balancing the benefits of reduction with the potential harms of undertreatment.

One example of an area that needs updating is the consideration of the age, currently missing from current guidance on hypertension management from government and medical bodies in the United States. However, European Society of Hypertension guidelines, updated in June 2023, recommend adults over age 80 or those classified as frail should be treated when their systolic blood pressure exceeds 160.

“For the first time, we have a chapter in the guidelines on hypertension and management in older people,” Reinhold Kreutz, MD, PhD, immediate past-president of the European Society of Hypertension, said. “If a patient has low blood pressure and symptoms such as dizziness or frailty, a reduction in medication should be considered.”

High blood pressure does not always present with noticeable symptoms, and patients do not always show up for an office visit in time for early intervention. It can pave the way for severe health complications including heart failure, stroke, kidney disease, heart attack, and, ultimately, death.

Grim statistics reveal its toll: Hypertension was a primary or contributing cause of nearly 700,000 deaths in the United States in 2021, and nearly half of adults have the condition. Only about one in four adults have their high blood pressure under control.
 

New Research Provides Insight

A recent study may provide needed insights for primary care clinicians: Gradually reducing hypertensive medication may not induce the feared fluctuations in blood pressure, contrary to prior concerns.

Researchers in Seoul, South Korea, analyzed the blood pressure of 83 patients diagnosed with hypertension who reduced their use of medication. They found that the use of less medication was associated with an increase in blood pressure readings taken at home but not in the clinic nor did it appear to influence blood pressure variability. The mean age of participants was 66 years.

Research shows systolic blood pressure variability is an important predictor of cardiovascular outcomes, as well as the risk for dementia.

When crafting treatment plans, clinicians should recognize the diverse factors at play for a particular patient, particularly concerning other health conditions.

Obesity, diabetes, and hyperlipidemia are among the common comorbidities often intertwined with hypertension. Because additional conditions come with more symptoms to consider and various medications, these health profiles demand tailored approaches to hypertension treatment.

Clinicians can recommend lifestyle modifications like dietary changes and regular exercise as first steps for patients who are diagnosed with grade 1 hypertension but who do not have cardiovascular disease, chronic kidney disease, diabetes, or organ damage. However, in cases where comorbidities are present or hypertension escalates to grade 2, clinicians should turn to medications for management, according to the International Society of Hypertension.

Patients with heart failure and reduced ejection fraction have unique challenges, according to Keith C. Ferdinand, MD, the Gereld S. Berenson Endowed Chair in Preventative Cardiology at the Tulane School of Medicine in New Orleans, Louisiana.

“Patients who have heart disease, they get a pump so the blood pressure comes down — but medicine is often needed to prevent further heart failure,” Dr. Ferdinand said.

Dr. Ferdinand stressed the importance of continuous medication to stave off further cardiac deterioration. He advocated for a cautious approach, emphasizing the continued use of medications like sacubitril/valsartan, beta-blockers, or sodium-glucose transport protein inhibitors to safeguard against heart failure progression.

Patients should also self-monitor blood pressure at home and be taught how to properly fit a cuff to enable accurate measurements. This approach empowers patients to actively engage in their health management and detect any deviations that warrant further attention, he said.
 

Medications for Hypertension

The use of any of the five major drug classes — angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium blockers, and thiazide/thiazide-like diuretics — and their combinations are recommended as the basis of antihypertensive treatment strategies.

Dr. Yang said primary care clinicians must be careful to decrease doses slowly. Central-acting medications such as clonidine and beta-blockers ultimately reduce heart rate and dilate blood vessels.

Decreasing the dose too quickly can create a rebound effect, and medication should be means reduced and closely monitored over the course of several weeks, Dr. Yang said.

“You cannot just withdraw abruptly with certain medications — you have to wean off slowly,” because patients may experience high blood pressure again, Dr. Yang said.

A version of this article appeared on Medscape.com.

Eugene Yang, MD, often confronts the complexities of weighing various medical interventions for high blood pressure. Among these is when to scale back antihypertensive drugs or stop them completely.

He considers a patient’s comorbidities, severity of symptoms, and risk factors for heart attack and stroke, among other variables. Central to this calculus is the recognition of age as a pivotal determinant of quality of life, according to Dr. Yang, the chair of the Prevention of Cardiovascular Disease Council at the American College of Cardiology.

For older adults, for example, the variance in functional status can be striking. One octogenarian may be bedbound due to severe dementia, while another might be playing pickleball three times a week.

“This happens to me in my practice all the time. I have patients who are restricted in mobility and have severe memory loss: Their functionality is quite poor,” Dr. Yang said. “In a patient where we have a limited life expectancy, where they have limited function or core memory, the goal is not to prolong life: It’s to make them more comfortable.”

Knowing when to deprescribe blood pressure medications is crucial. For some, lifestyle changes can do the trick. For others, particularly older patients, their comorbid conditions and medication regimens need to be considered.

“There’s a recognition that we need to move to a new paradigm where we need to decide when to be aggressive and when to be less aggressive,” Dr. Yang said.

The American Heart Association and the American College of Cardiology most recently released guidelines in 2017, changing the cutoff for diagnosis from 140/90 to 130/80 mm Hg. The groups have issued no updates since then, leaving primary care physicians and their colleagues to navigate this territory with caution, balancing the benefits of reduction with the potential harms of undertreatment.

One example of an area that needs updating is the consideration of the age, currently missing from current guidance on hypertension management from government and medical bodies in the United States. However, European Society of Hypertension guidelines, updated in June 2023, recommend adults over age 80 or those classified as frail should be treated when their systolic blood pressure exceeds 160.

“For the first time, we have a chapter in the guidelines on hypertension and management in older people,” Reinhold Kreutz, MD, PhD, immediate past-president of the European Society of Hypertension, said. “If a patient has low blood pressure and symptoms such as dizziness or frailty, a reduction in medication should be considered.”

High blood pressure does not always present with noticeable symptoms, and patients do not always show up for an office visit in time for early intervention. It can pave the way for severe health complications including heart failure, stroke, kidney disease, heart attack, and, ultimately, death.

Grim statistics reveal its toll: Hypertension was a primary or contributing cause of nearly 700,000 deaths in the United States in 2021, and nearly half of adults have the condition. Only about one in four adults have their high blood pressure under control.
 

New Research Provides Insight

A recent study may provide needed insights for primary care clinicians: Gradually reducing hypertensive medication may not induce the feared fluctuations in blood pressure, contrary to prior concerns.

Researchers in Seoul, South Korea, analyzed the blood pressure of 83 patients diagnosed with hypertension who reduced their use of medication. They found that the use of less medication was associated with an increase in blood pressure readings taken at home but not in the clinic nor did it appear to influence blood pressure variability. The mean age of participants was 66 years.

Research shows systolic blood pressure variability is an important predictor of cardiovascular outcomes, as well as the risk for dementia.

When crafting treatment plans, clinicians should recognize the diverse factors at play for a particular patient, particularly concerning other health conditions.

Obesity, diabetes, and hyperlipidemia are among the common comorbidities often intertwined with hypertension. Because additional conditions come with more symptoms to consider and various medications, these health profiles demand tailored approaches to hypertension treatment.

Clinicians can recommend lifestyle modifications like dietary changes and regular exercise as first steps for patients who are diagnosed with grade 1 hypertension but who do not have cardiovascular disease, chronic kidney disease, diabetes, or organ damage. However, in cases where comorbidities are present or hypertension escalates to grade 2, clinicians should turn to medications for management, according to the International Society of Hypertension.

Patients with heart failure and reduced ejection fraction have unique challenges, according to Keith C. Ferdinand, MD, the Gereld S. Berenson Endowed Chair in Preventative Cardiology at the Tulane School of Medicine in New Orleans, Louisiana.

“Patients who have heart disease, they get a pump so the blood pressure comes down — but medicine is often needed to prevent further heart failure,” Dr. Ferdinand said.

Dr. Ferdinand stressed the importance of continuous medication to stave off further cardiac deterioration. He advocated for a cautious approach, emphasizing the continued use of medications like sacubitril/valsartan, beta-blockers, or sodium-glucose transport protein inhibitors to safeguard against heart failure progression.

Patients should also self-monitor blood pressure at home and be taught how to properly fit a cuff to enable accurate measurements. This approach empowers patients to actively engage in their health management and detect any deviations that warrant further attention, he said.
 

Medications for Hypertension

The use of any of the five major drug classes — angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium blockers, and thiazide/thiazide-like diuretics — and their combinations are recommended as the basis of antihypertensive treatment strategies.

Dr. Yang said primary care clinicians must be careful to decrease doses slowly. Central-acting medications such as clonidine and beta-blockers ultimately reduce heart rate and dilate blood vessels.

Decreasing the dose too quickly can create a rebound effect, and medication should be means reduced and closely monitored over the course of several weeks, Dr. Yang said.

“You cannot just withdraw abruptly with certain medications — you have to wean off slowly,” because patients may experience high blood pressure again, Dr. Yang said.

A version of this article appeared on Medscape.com.

Implementing strategies to optimize electronic health record (EHR) use can save time, improve the doctor-patient relationship, and reduce burnout, a new practice management article suggests.

Michelle Kang Kim, MD, PhD, AGAF, chair of gastroenterology at Cleveland Clinic, Ohio, and colleagues provide EHR improvement strategies and examples that can be adapted for use in a variety of gastroenterology clinic settings. 

Their article, which was published online in Clinical Gastroenterology and Hepatology , includes the following suggestions, among others:

• Develop optimization teams. An example is SPRINT, a short, intensive team-based intervention at the University of Colorado Health, Aurora, Colorado, that developed specialty-specific tools, provided EHR efficiency training, and helped streamline workflows. The optimization project increased EHR satisfaction scores and reduced documentation time.
• Reroute low-acuity messages. Low-risk medication refills or appointment requests can be handled by nurses and medical assistants. This strategy has helped reduce the inbox burden.
• Create order sets for complex treatment dosing. One example is Cleveland Clinic’s Helicobacter pylori order set, which enables clinicians to quickly place orders with built-in dosages.
• Personalize EHR drop-down menus. Incorporate inflammatory bowel disease (IBD) severity scores, biopsy sampling, resection protocols, specimen container numbering, and other workflow-specific documentation into the EHR.
• Employ medical scribes. These professionals can serve as personal assistants, supporting care teams and reducing clinician documentation time. Alternatively, clinical support staff, such as nurses, can assist with documentation and messages, helping to reduce physician burnout. “These models could be particularly useful in GI specialties that require a multidisciplinary approach, for example, IBD and hepatology,” the authors write.
• Provide real-time training on best practices. There is no widely accepted EHR training curriculum for students, and experienced physicians face time constraints in learning new practices. Real-time training can help clinicians at all levels optimize their time outside the clinic.

In addition, the authors addressed novel tools and strategies that have been recently deployed and/or are in development, which are based largely on artificial intelligence (AI), natural language processing, and speech recognition. For now, these tools are digitizing data to help automate some EHR tasks, supporting communications with patients, and assisting in clinical decision making.

However, the authors note that although current optimization tools are promising, “there is still a lack of knowledge about their usability and effects on provider and patient well-being. More research is needed to evaluate current methodologies and design intelligent tools for the future that will help GI providers overcome the EHR-related obstacles specific to our field and harness the enormous potential of AI in optimizing the busy GI practice.”

This work received no external funding, and the authors disclosed no conflicts. 

A version of this article appeared on Medscape.com.

Implementing strategies to optimize electronic health record (EHR) use can save time, improve the doctor-patient relationship, and reduce burnout, a new practice management article suggests.

Michelle Kang Kim, MD, PhD, AGAF, chair of gastroenterology at Cleveland Clinic, Ohio, and colleagues provide EHR improvement strategies and examples that can be adapted for use in a variety of gastroenterology clinic settings. 

Their article, which was published online in Clinical Gastroenterology and Hepatology , includes the following suggestions, among others:

• Develop optimization teams. An example is SPRINT, a short, intensive team-based intervention at the University of Colorado Health, Aurora, Colorado, that developed specialty-specific tools, provided EHR efficiency training, and helped streamline workflows. The optimization project increased EHR satisfaction scores and reduced documentation time.
• Reroute low-acuity messages. Low-risk medication refills or appointment requests can be handled by nurses and medical assistants. This strategy has helped reduce the inbox burden.
• Create order sets for complex treatment dosing. One example is Cleveland Clinic’s Helicobacter pylori order set, which enables clinicians to quickly place orders with built-in dosages.
• Personalize EHR drop-down menus. Incorporate inflammatory bowel disease (IBD) severity scores, biopsy sampling, resection protocols, specimen container numbering, and other workflow-specific documentation into the EHR.
• Employ medical scribes. These professionals can serve as personal assistants, supporting care teams and reducing clinician documentation time. Alternatively, clinical support staff, such as nurses, can assist with documentation and messages, helping to reduce physician burnout. “These models could be particularly useful in GI specialties that require a multidisciplinary approach, for example, IBD and hepatology,” the authors write.
• Provide real-time training on best practices. There is no widely accepted EHR training curriculum for students, and experienced physicians face time constraints in learning new practices. Real-time training can help clinicians at all levels optimize their time outside the clinic.

In addition, the authors addressed novel tools and strategies that have been recently deployed and/or are in development, which are based largely on artificial intelligence (AI), natural language processing, and speech recognition. For now, these tools are digitizing data to help automate some EHR tasks, supporting communications with patients, and assisting in clinical decision making.

However, the authors note that although current optimization tools are promising, “there is still a lack of knowledge about their usability and effects on provider and patient well-being. More research is needed to evaluate current methodologies and design intelligent tools for the future that will help GI providers overcome the EHR-related obstacles specific to our field and harness the enormous potential of AI in optimizing the busy GI practice.”

This work received no external funding, and the authors disclosed no conflicts. 

A version of this article appeared on Medscape.com.

Implementing strategies to optimize electronic health record (EHR) use can save time, improve the doctor-patient relationship, and reduce burnout, a new practice management article suggests.

Michelle Kang Kim, MD, PhD, AGAF, chair of gastroenterology at Cleveland Clinic, Ohio, and colleagues provide EHR improvement strategies and examples that can be adapted for use in a variety of gastroenterology clinic settings. 

Their article, which was published online in Clinical Gastroenterology and Hepatology , includes the following suggestions, among others:

• Develop optimization teams. An example is SPRINT, a short, intensive team-based intervention at the University of Colorado Health, Aurora, Colorado, that developed specialty-specific tools, provided EHR efficiency training, and helped streamline workflows. The optimization project increased EHR satisfaction scores and reduced documentation time.
• Reroute low-acuity messages. Low-risk medication refills or appointment requests can be handled by nurses and medical assistants. This strategy has helped reduce the inbox burden.
• Create order sets for complex treatment dosing. One example is Cleveland Clinic’s Helicobacter pylori order set, which enables clinicians to quickly place orders with built-in dosages.
• Personalize EHR drop-down menus. Incorporate inflammatory bowel disease (IBD) severity scores, biopsy sampling, resection protocols, specimen container numbering, and other workflow-specific documentation into the EHR.
• Employ medical scribes. These professionals can serve as personal assistants, supporting care teams and reducing clinician documentation time. Alternatively, clinical support staff, such as nurses, can assist with documentation and messages, helping to reduce physician burnout. “These models could be particularly useful in GI specialties that require a multidisciplinary approach, for example, IBD and hepatology,” the authors write.
• Provide real-time training on best practices. There is no widely accepted EHR training curriculum for students, and experienced physicians face time constraints in learning new practices. Real-time training can help clinicians at all levels optimize their time outside the clinic.

In addition, the authors addressed novel tools and strategies that have been recently deployed and/or are in development, which are based largely on artificial intelligence (AI), natural language processing, and speech recognition. For now, these tools are digitizing data to help automate some EHR tasks, supporting communications with patients, and assisting in clinical decision making.

However, the authors note that although current optimization tools are promising, “there is still a lack of knowledge about their usability and effects on provider and patient well-being. More research is needed to evaluate current methodologies and design intelligent tools for the future that will help GI providers overcome the EHR-related obstacles specific to our field and harness the enormous potential of AI in optimizing the busy GI practice.”

This work received no external funding, and the authors disclosed no conflicts. 

A version of this article appeared on Medscape.com.