Impact of atopic dermatitis on health-related quality of life and productivity in adults in the United States: An analysis using the National Health and Wellness Survey

Eckert, Laurent; Gupta, Shaloo; Amand, Caroline; Gadkari, Abhijit; Mahajan, Pooja; Gelfand, Joel M.

doi:10.1016/j.jaad.2017.04.019

Cited by 181 publications

(165 citation statements)

References 25 publications

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“…As expected, the work impairment was lowest in the participants with mild AD. This is in line with previous reports based on data from the 2013 U.S. NHWS, where respondents with moderate‐to‐severe AD generally showed a higher disease burden than respondents with mild AD . This is now also shown to be consistent across regions.…”

Section: Discussionsupporting

confidence: 91%

“…Being a chronically relapsing condition, AD is associated with a high disease burden, with a significant physical and social impact. AD has been reported to have a detrimental effect on health‐related quality of life, including aspects such as sleep disturbance and reductions in work productivity . However, the burden of AD in adult patients has still not been well characterized .…”

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confidence: 99%

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Increasing severity of atopic dermatitis is associated with a negative impact on work productivity among adults with atopic dermatitis in France, Germany, the U.K. and the U.S.A.

2019

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Summary Background Atopic dermatitis (AD) is associated with high disease burden, with a significant physical and social impact. However, the association between disease severity and burden of disease, with work productivity and daily activities being one aspect, has not been well characterized. Objectives To investigate the impact of disease severity on work productivity and daily activities among adults with AD in Europe (France, Germany and the U.K.) and the U.S.A. Methods The survey panel participants for this cross‐sectional internet‐based survey on AD were sourced from the population‐based National Health and Wellness Survey (Europe 2016, U.S.A. 2015 and 2016). AD severity was determined by Patient‐Oriented Scoring Atopic Dermatitis (PO‐SCORAD). Work productivity and work activity impairment were assessed using the Work Productivity and Activity Impairment (WPAI) – Specific Health Problem questionnaire for AD. Results The study survey was completed by 1098 respondents with moderate‐to‐severe AD and 134 with mild AD. Overall, the negative impact on work productivity (all WPAI items) was suggested to increase with increasing AD severity (PO‐SCORAD) at the regional level (Europe and U.S.A.) and in the total sample. For overall work impairment due to AD, respondents with mild AD reported a mean of 2·4 h per week of potential work productivity lost, respondents with moderate AD 9·6 h and respondents with severe AD 19·0 h. Conclusions Higher AD severity was associated with a greater negative impact on work productivity in adults. This impact is a burden not only for the patient but also for society and may provide incentives for treatment optimization and more effective management of AD. What's already known about this topic? Atopic dermatitis (AD) is associated with a high disease burden. AD has a negative impact on several aspects of health‐related quality of life, one of which is work productivity. What does this study add? By using a population of participants with AD recruited from the National Health and Wellness Survey, which collects broad and representative data from the general population, survey data could be obtained from U.S. and European populations of patients with AD. The present study suggests an increasingly negative impact on work productivity with increasing severity of AD. The data indicate no regional differences in the impact of AD severity on work productivity.

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Section: Discussionsupporting

confidence: 91%

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confidence: 99%

Increasing severity of atopic dermatitis is associated with a negative impact on work productivity among adults with atopic dermatitis in France, Germany, the U.K. and the U.S.A.

2019

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“…A systematic review revealed an association between autism spectrum disorders and AD, even though the authors stated somewhat inconsistent results due to variability in the study population and design, and the presence of other risk factors acting as confounding factors [30]. An increased risk of depression has been noted in both adolescents and adults affected with AD [23, 31]. AD patients have a significantly higher frequency of suicidal ideation, anxiety, and depression compared to healthy controls [32, 33].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…In addition to anxiety, depression, and sleep disorders, patients with AD report higher rates of mental and physical disturbances, work absenteeism, and activity impairment compared to non-AD controls [31]. …”

Section: Clinical Presentationmentioning

confidence: 99%

Atopic Dermatitis: Collegium Internationale Allergologicum (CIA) Update 2019

Simon

Wollenberg

Renz

et al. 2019

Int Arch Allergy Immunol

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Atopic dermatitis (AD) is a chronic inflammatory skin disease presenting with recurrent eczematous lesions and intense pruritus. It is common and affects both children and adults, often beginning in infancy. Due to the unpredictable disease course, its visible skin lesions, itching and scratching followed by sleeplessness, other associated atopic diseases, and behavioral and psychiatric disorders, AD is an immense burden for patients and caregivers. AD is determined by a genetic predisposition characterized by an impaired skin barrier and a T-helper-2-predominant inflammation. Restoration of the skin barrier is the main approach for treating and preventing AD. In order to cope with acute flares, usually topical corticosteroids (TCS) are applied, while topical calcineurin inhibitors (TCI) are used mainly for maintenance therapy. There is a small group of patients who are refractory to TCS and TCI and require systemic immunosuppressive drugs such as ciclosporin. Novel, targeted therapies are under clinical investigation, among which an anti-IL-4/IL-13 receptor antibody has recently been approved in several countries. As we learn to understand the pathomechanisms of AD, the characteristics of the different patient subgroups, and the effectiveness of various targeted therapies, a personalized treatment ensuring the best efficacy and safety and, probably, a disease-modifying effect will result.

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“…Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects approximately 15%–30% of children and 2%–10% of adults worldwide . In addition to eczematous lesions, intense pruritus and a high burden of disease in affected patients are associated with AD . AD has been shown to have a large impact on health‐related quality of life (QoL) in adults and children with AD and their caregivers, affecting social functioning, emotional well‐being and academic and occupational pursuits .…”

Section: Introductionmentioning

confidence: 99%

Examining the association between pruritus and quality of life in patients with atopic dermatitis treated with crisaborole

Ständer

Yosipovitch

Bushmakin

et al. 2019

Acad Dermatol Venereol

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Background Pruritus is a leading cause of reduced health‐related quality of life (QoL) in atopic dermatitis (AD). Crisaborole ointment is a non‐steroidal phosphodiesterase 4 inhibitor for the treatment of mild‐to‐moderate AD. In identical Phase 3 studies (NCT02118766, NCT02118792), crisaborole reduced disease and pruritus severity versus vehicle. Objective Quantify the relationship between pruritus and QoL using data from these studies. Methods Patients aged ≥2 years were randomly assigned 2 : 1 to receive crisaborole:vehicle twice daily for 28 days. QoL was measured at baseline and day 29 using the Dermatology Life Quality Index (DLQI; patients aged ≥16 years), the Children's Dermatology Life Quality Index (CDLQI; patients aged 2–15 years) and the Dermatitis Family Impact (DFI; caregivers of patients aged 2–17 years). Pruritus was measured using the Severity of Pruritus Scale (SPS), a 4‐point scale from 0 (‘no itching’) to 3 (‘bothersome itching/scratching that disturbs sleep’), and captured morning and evening via electronic diary. Data from crisaborole and vehicle arms were pooled for this analysis. A repeated‐measures longitudinal model was used to estimate relationships between pruritus (SPS) and QoL (DLQI, CDLQI and DFI in separate analyses). Results One thousand five hundred and twenty two patients received crisaborole or vehicle. A linearity assumption for the relationship between SPS and DLQI (n = 294), CDLQI (n = 1200), and DFI (n = 1293) was appropriate. For DLQI, SPS score of 0 was associated with ‘no negative effect on patient QoL’; SPS score of 1 was associated with ‘small effect on patient QoL’; SPS score of 2 was associated with ‘moderate effect on patient QoL’; and SPS score of 3 was associated with ‘very large effect on patient QoL’. The pattern of relationships between SPS and CDLQI and DFI was similar. Conclusions The relationships between SPS and DLQI, CDLQI and DFI substantiate the significant link between pruritus and patient/caregiver QoL in AD.

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Impact of atopic dermatitis on health-related quality of life and productivity in adults in the United States: An analysis using the National Health and Wellness Survey

Abstract: AD is associated with a substantial humanistic burden that is similar in magnitude to that of psoriasis, which is also recognized for its debilitating symptoms, indicating the need for more effective treatments for AD.

Cited by 181 publications

References 25 publications

Increasing severity of atopic dermatitis is associated with a negative impact on work productivity among adults with atopic dermatitis in France, Germany, the U.K. and the U.S.A.

Increasing severity of atopic dermatitis is associated with a negative impact on work productivity among adults with atopic dermatitis in France, Germany, the U.K. and the U.S.A.

Atopic Dermatitis: Collegium Internationale Allergologicum (CIA) Update 2019

Examining the association between pruritus and quality of life in patients with atopic dermatitis treated with crisaborole

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