Understanding the Care Journey and Unmet Needs of Children with Mild-to-Moderate Atopic Dermatitis and Their Caregivers: Results from a Multi-Country Qualitative Study

Objectives: To understand the experiences of patients with mild-to-moderate atopic dermatitis (AD) and their caregivers, the impact on everyday life, and identify unmet needs throughout the care journey. Methods: This was a qualitative study including 120 patients aged ≥3 months–17 years with mild-to-moderate AD and their caregivers, conducted across China, Saudi Arabia, Spain, and Portugal. Participants were recruited from both public and private healthcare settings. Data were collected through 75-minute remote, semi-structured interviews and three 5-minute video diaries. Data were coded and analysed using an inductive and deductive thematic approach. Results: AD significantly impacted patients and caregivers across three key areas: lifestyle adjustments, emotional well-being, and future concerns. Reported challenges included activity limitations, food restrictions, and disruptions to caregiver work–life balance. Emotional impacts such as anxiety, bullying, self-image concerns, and peer avoidance were common. Caregivers also expressed concerns about disease chronicity and academic success. Unmet needs included: limited knowledge and information, restricted access to specialists and government aid, insufficient support for disease management, inconvenient emollients, lack of support for positive self-image, inadequate life-stage guidance, and lack of recognition of gender norms. Limitations: The retrospective design may have introduced selection and misclassification biases. In addition, asking participants to recall their full care journey adds a relevant risk of recall bias, particularly for those with a longer disease history. This reliance on long-term memory may have affected the accuracy of reports about early symptoms, decisions, or emotions. Virtual interviews may also have increased social desirability bias and limited non-verbal observations. Conclusions: This study reveals that AD affects not only daily life but also emotional well-being and future outlook. Addressing the unmet needs requires holistic strategies combining education, improved communication, and digital tools across life stages.