Higher self‐reported severity of atopic dermatitis in adults is associated with poorer self‐reported health‐related quality of life in France, Germany, the U.K. and the U.S.A.

Abstract

Summary Background Better understanding of the relationship between atopic dermatitis (AD) severity and health‐related quality of life (HRQoL) could help improve knowledge of a more effective treatment for people with AD. Objectives To assess the relationship between AD severity and HRQoL and perception of AD symptoms in adults with moderate‐to‐severe AD in Europe and the U.S.A. Methods Participants for this cross‐sectional, internet‐based survey were recruited from the larger population‐based National Health and Wellness Survey. AD severity was measured by Patient‐Oriented SCORing of AD. HRQoL was measured by the five‐level EuroQol‐5D, Dermatology Life Quality Index (DLQI) and Patient‐Oriented Eczema Measure (POEM). Results Altogether, 1232 respondents were included: 1098 (89·1%) with moderate‐to‐severe AD [221 (20·1%) from France, 209 (19·0%) from Germany, 118 (10·7%) from the U.K. and 550 (50·1%) from the U.S.A.]. An additional 134 (10·9%) respondents with mild AD were included. Sociodemographic and clinical AD characteristics were similar between countries. In adults with moderate‐to‐severe AD, higher AD severity correlated with poorer HRQoL (Spearman's r = –0·38 and 0·61 for EQ‐5D and DLQI, respectively; both P < 0·001). AD severity was positively correlated with POEM (Spearman's r = 0·51; P < 0·001). People with moderate‐to‐severe vs. those with mild AD had poorer health outcomes (EQ‐5D, DLQI and POEM, P < 0·001 for all). These results were similar and consistent for the European and the U.S. populations separately. Conclusions Higher AD severity is associated with poorer HRQoL across Europe and the U.S.A. This is a burden for patients and may provide encouragement for more effective management of AD. What's already known about this topic? Atopic dermatitis (AD) is associated with a detrimental effect on health‐related quality of life (HRQoL), including sleep disturbance, anxiety and depression. Limited data describing the relationship between different levels of AD severity and self‐reported HRQoL have been published. What does this study add? There is a positive association between increasing AD severity (Patient‐Oriented SCORing of AD) and decreasing HRQoL (EQ‐5D and Dermatology Life Quality Index) and the perception of AD symptoms (Patient‐Oriented Eczema Measure) from the patient's perspective. AD severity according to geographic locations was explored (France, Germany, the U.K., and the U.S.A.), showing that the decreasing HRQoL associated with increasing AD severity was quite consistent between the geographic locations. What are the clinical implications of this work? The results of this study showed that higher AD severity is associated with poorer HRQoL from the subject’s perspective in both Europe and the US. This fact confirms that there is a burden for these patients and may provide encouragement for a more effective management of AD, especially among those with greater AD severity.

Perception of the coronavirus pandemic by patients with atopic dermatitis – Results from the TREATgermany registry

“…In the observed patients, the examination of associations with subjective disease severity showed significant correlations between a higher burden due to the coronavirus pandemic and lower values for DLQI and PGA. AD is known to be associated with various social and occupational effects, as well as direct or indirect stress factors or effects on patients and their quality of life [59][60][61][62][63][64][65]. As implied by the German name of the disease, "neurodermitis", and the interaction of mental and physical involvement of AD patients [66], a basic assumption of the present study was that a higher subjective symptom severity may be associated with higher burden scores.…”

Validity of EQ‐5D‐5L, Skindex‐16, DLQI and DLQI‐R in patients with hidradenitis suppurativa

“…24 Among generic HRQoL tools, the EQ-5D is one of the most widely used questionnaires that demonstrated good validity and responsiveness in patients with chronic skin diseases, such as psoriasis, atopic dermatitis and pemphigus. [25][26][27][28] Clinical data collected with the EQ-5D can also be used when assessing cost-effectiveness of health interventions. It has two versions suitable for adults, the EQ-5D-3L and the newer EQ-5D-5L.…”

“…Validation of Skindex‐16 is also currently incomplete in this patient population 24 . Among generic HRQoL tools, the EQ‐5D is one of the most widely used questionnaires that demonstrated good validity and responsiveness in patients with chronic skin diseases, such as psoriasis, atopic dermatitis and pemphigus 25–28 . Clinical data collected with the EQ‐5D can also be used when assessing cost‐effectiveness of health interventions.…”

Cross‐country generalizability of quality‐of‐life scores in atopic dermatitis

“…The study by Andersen et al . is the first in the literature to estimate EQ‐5D‐5L index and EQ VAS scores for PO‐SCORAD score bands . EQ VAS scores indicated worse HRQoL in patients with higher self‐reported disease severity.…”

“…In this issue of the BJD , Andersen et al . present the results of a large online survey about self‐reported severity and HRQoL in 1232 patients with AD from four countries (France, Germany, the U.K. and the U.S.A.) . The sociodemographic and clinical characteristics of the patients were well matched between the European and U.S. patient populations.…”