Estudo da qualidade de vida nos pacientes com urticária crônica

Abstract

BACKGROUND: Chronic urticaria affects patients by interfering with their daily activities, damaging their self-esteem and negatively affecting their interpersonal relationships. Healthcare professionals may underestimate the impact of the condition on patients' quality of life. OBJECTIVES: To evaluate quality of life using one generic and one disease-specific health-related quality of life instrument; to compare quality of life between the different clinical types of chronic urticaria and to evaluate whether angioedema further impairs quality of life. METHODS: Sixty-two patients with chronic urticaria, who had had signs or symptoms of the disease within the preceding week, were divided into groups according to whether they had ordinary chronic urticaria, physical chronic urticaria or mixed chronic urticaria. RESULTS: There was a predominance of women in this study (72.6%). The mean age of patients was 39.8 years and angioedema was associated with chronic urticaria in 75.8% of cases. Associated angioedema was more commonly found in patients with ordinary chronic urticaria (p=0.011) and in women (p=0.024). With respect to the different clinical types, 32.3% of the patients had ordinary chronic urticaria, 27.4% had physical chronic urticaria and 40.3% had mixed chronic urticaria. Mean overall score for the disease-specific questionnaire was 10.4. In this questionnaire, the most affected domains were "symptoms and feelings" and "daily activities", while the most affected domains in the SF-36 were "physical role" and "vitality". Quality of life was found to be impaired in women, in patients of up to 30 years of age, in those attending a first consultation, in those with higher education levels, in patients who had had the disease for up to one year and in those with angioedema. CONCLUSIONS: Chronic urticaria affects quality of life, as measured using a disease-specific questionnaire and a generic questionnaire. There was no statistically significant difference between the clinical types. The presence of angioedema impaired patients' quality of life even further. There was a statistically significant correlation between the scores obtained using the disease-specific questionnaire and those obtained using the generic questionnaire. Keywords: Angioedema; Quality of life; Questionnaires; Sickness impact profile; Urticaria Resumo: FUNDAMENTOS: A urticária crônica compromete o doente por interferir nas atividades diárias, prejudicar a autoestima e as relações interpessoais. Os profissionais de saúde subestimam seu impacto na qualidade de vida dos doentes. OBJETIVOS: Avaliar a qualidade de vida com questionário específico e genérico. Compará-la entre os tipos clínicos de urticária crônica e avaliar se o angioedema piora a qualidade de vida. MÉTODOS: Participaram 62 doentes com urticária crônica, com sinais e sintomas da doença até 7 dias da consulta, que foram divididos em urticária crônica comum, urticária crônica física e urticária crônica mista. RESULTADOS: Observou-se predominância de mulheres (72,6%), idade m...

The Burden of Chronic Urticaria from Brazilian Patients’ Perspective

“…For example, one study, which was conducted at an outpatient clinic in Sao Paulo, indicated that respondents with CU reported via the Dermatology Life Quality Index (DLQI) a negative impact on their ability to participate in daily and leisure activities, as well as experiencing uncomfortable symptoms (e.g., itching) and feelings of embarrassment from their condition [ 30 ]. Another study conducted in a Sao Paulo outpatient clinic assessed HRQoL using the SF-36 domain scores and the DLQI [ 31 ]. Although the aforementioned study was mainly concerned with comparing HRQoL among different types of CU, regardless of type, CU was associated with significant impairment in work activities, daily activities, and high levels of fatigue [ 31 ].…”

Impact of chronic urticaria on the quality of life of patients followed up at a university hospital

“…33 A study published in 2011 using DLQI and SF-36, a generic instrument to evaluate quality of life, demonstrated greater impairment in: women, patients aged up to 30, those experiencing their first visit, patients with a high level of education, those who had the disease for up to 1 year, and angioedema patients. 31 In another Brazilian study published in 2011, the patients had a mean score of 13.5 in the DLQI (0-30), the presence of angioedema was associated with higher scores (14.3; p < 0.01); women were more limited with respect to clothing and men with respect to work and study (p < 0.05). 34 In these studies, the presence of angioedema and being female were associated with a worse quality of life.…”

“…12,31 Women likely have more sensitive skin and mental awareness toward the symptoms of hives and are more influenced by changes in appearance. In fact, a greater impact was found in all dimensions for women, though there was no statistical significance.…”

State of the art of chronic spontaneous urticaria in Italy: a multicentre survey to evaluate physicians’ and patients’ perspectives

“…Attending multiple medical centres due to dissatisfaction with treatment and reports of reduced QoL are in accordance with existing literature in patients with CSU. 4 6–8 A patient survey conducted in Germany and France also reiterated the impact CSU has on QoL and lack of satisfaction with physician care, 16 with patients indicating they were only ‘somewhat satisfied’ with the care they were receiving. Satisfaction with treatment increased if the physician discussed the impact of CSU on emotions with their patient.…”

“… 5 Furthermore, CSU can have a significant impact on the patient's quality of life (QoL), and patients with CSU often experience depression and anxiety related to the disease. 4 6–8 Failed attempts to treat long-term symptoms can often lead to frustration on the part of the patient and the physician, 5 and patients with long-term unresolved symptoms often present to a number of physicians in varying specialties in an attempt to seek relief. 4 …”