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

Publication date: Available online 16 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): J.I. Silverberg, J.M. Gelfand, D.J. Margolis, M. Boguniewicz, L. Fonacier, M.H. Grayson, E.L. Simpson, P.Y. Ong, Z.C. Chiesa Fuxench

Abstract

Background

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

Objective

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

Methods

A cross-sectional, population-based study of 602 adults was performed. AD was determined using modified UK Diagnostic Criteria for AD. AD severity was assessed using self-reported global AD severity, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Scoring AD (POSCORAD), PO-SCORAD-itch and sleep. QOL 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 [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 socio-demographics and multiple comorbid health disorders, there were 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. SF-12 physical health scores were only associated with moderate AD. Concurrently severe PO-SCORAD, POEM and/or PO-SCORAD-itch was associated with very low mean SF-12 mental health (34.7) and high DLQI scores (24.7). AD 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 moderate and severe AD.

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