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Ann Allergy Asthma Immunol. 2018 Sep;121(3):340-347. doi: 10.1016/j.anai.2018.07.006. Epub 2018 Jul 16.

Patient burden and quality of life in atopic dermatitis in US adults: A population-based cross-sectional study.

Author information

1
Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: JonathanISilverberg@gmail.com.
2
University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
3
National Jewish Health and University of Colorado School of Medicine, Denver, Colorado.
4
NYU Winthrop Hospital, Mineola, New York.
5
Nationwide Children's Hospital-The Ohio State University College of Medicine, Columbus, Ohio.
6
Oregon Health & Science University, Portland, Oregon.
7
Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, California.

Abstract

BACKGROUND:

The patient burden and quality of life (QOL) impact of atopic dermatitis (AD) in the United States population is not well established.

OBJECTIVE:

To elucidate the patient burden of AD in the US population.

METHODS:

A cross-sectional, population-based study of 602 adults was performed. Atopic dermatitis was determined using modified UK Diagnostic Criteria for AD. Its severity was assessed using self-reported global AD severity, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Scoring AD (PO-SCORAD), PO-SCORAD-itch, and sleep. Quality of life was assessed using short-form (SF-)12 mental and physical health scores and Dermatology Life Quality Index (DLQI).

RESULTS:

Adults with AD reported higher proportions of having only fair/poor overall health (25.8% vs. 15.8%), being somewhat/very dissatisfied with life (16.7% vs 11.4%), lower weighted mean (standard deviation [SD]) SF-12 mental (45.9 [9.9] vs 50.9 [9.2]) and physical health subscores (53.0 [2.5] vs 53.5 [2.3]) and higher DLQI (4.9 [6.5] vs 1.1 [2.8]). In multivariable regression models adjusting for sociodemographics and multiple comorbid health disorders, significant stepwise decreases by AD severity (self-reported, POEM, PO-SCORAD) of overall health, life satisfaction, SF-12 mental health, and increases of DLQI scores were seen. The SF-12 physical health scores were only associated with moderate AD. Concurrently, severe PO-SCORAD, POEM, or PO-SCORAD-itch was associated with very low mean SF-12 mental health (34.7) and high DLQI scores (24.7). Atopic dermatitis commonly limited lifestyle (51.3%), led to avoidance of social interaction (39.1%), and impacted activities (43.3%). The most burdensome AD symptoms were itch (54.4%), excessive dryness/scaling (19.6%), and red/inflamed skin (7.2%).

CONCLUSION:

These data support the heavy burden that AD places on patients, particularly those with moderate and severe AD.

PMID:
30025911
DOI:
10.1016/j.anai.2018.07.006
[Indexed for MEDLINE]
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