Living with Atopic Dermatitis as a Young Adult in Relation to Health-related Quality of Life and Healthcare Contacts: A Population-based Study

Abstract

Most studies of health-related quality of life (HRQoL) and atopic dermatitis are based on data from dermatology clinics. The aim of this study was to determine whether atopic dermatitis affects HRQoL in adolescence and young adulthood, based on data from the population-based cohort BAMSE (Children, Allergy, Environmental, Stockholm, Epidemiology). A further aim was to determine if the use of topical corticosteroids and healthcare contacts affect HRQoL. Participants with data from birth to young adulthood (n=3,064) were included. Two generic instruments were used to measure HRQoL:General Health at age 12, 16 and 24 years and EQ-5D-3L, including EQ-visual analogue scale (EQ-VAS) at age 24 years. In addition, the disease-specific Dermatology Quality Life Index (DLQI) was used at 24 years. Healthcare consultations for atopic dermatitis were obtained from Stockholm Regional Healthcare Data Warehouse (n = 1,944). Participants with atopic dermatitis had an increased odds ratio (OR) of not feeling completely healthy (adjusted OR 1.50; 95% confidence interval (95% CI): 1.30–1.73). Participants with persistent atopic dermatitis, fulfilling atopic dermatitis criteria in the 12- and/or 16- and 24-year follow-ups reported worse EQ-VAS value 70.0 (95% CI 67.3–72.7) in the 25th percentile, than peers without atopic dermatitis. Over an 8-year period, contact with healthcare was limited (mean number 0.96). In conclusion, atopic dermatitis had a negative impact on HRQoL in young adults from adolescence to adulthood and healthcare consultations were few.

Health-related quality of life decreases in young people with asthma during the transition from adolescence to young adulthood: a birth cohort study

“…Persistent asthma: asthma at the 16-or 24-year follow-up and at least one earlier follow-up (1-, 2-, 4-, 8-or 12-year follow-ups) e p values indicate differences between crude median EuroQol visual analogue scale scores and asthma at the 24-year follow-up, obtained using quantile regression f p values indicate differences between adjusted median EuroQol visual analogue scale scores and asthma at the 24-year follow-up, obtained using quantile regression. Adjusted for sex, family history of allergic disease and socio-economic status g Missing values due to missing data of EuroQol visual analogue scale scores at 24-year follow-up or one or more of the confounding variables: sex, family history of allergic disease and socio-economic status EuroQol visual analogue scale scores at 24 Our results are in accordance with recent results from the PIAMA birth cohort, where decreased mental well-being and general health were seen from age 17 to 20 years among participants both with and without asthma [29]. In the present study, HRQoL decreased among young adults with asthma, and more problems were reported in three out of five health attributes in young adulthood compared with in adolescence.…”

“…Three simple general questions yielded an overall assessment of health, both mental and physical [ 23 , 24 ]. The questions, response options (dichotomous variables were constructed) and reference groups were (1) ‘How are you feeling?’, Not good/fairly good/good vs. Excellent/very good (used as reference).…”

Childhood atopic dermatitis is associated with cardiovascular risk factors in young adulthood—A population‐based cohort study

“…Moreover, earlier studies have shown that adolescents and young adults with AD are under-treated and have few healthcare contacts. 32,33…”

“…In the present study, we found an association between current AD with prepubertal onset and early signs of CVD risk factors in young adulthood. Moreover, earlier studies have shown that adolescents and young adults with AD are under‐treated and have few healthcare contacts 32,33 …”

The Efficacy and Effectiveness of the Biological Treatment of Pruritus in the Course of Atopic Dermatitis

“…The clinical manifestation of atopic dermatitis varies depending on the age of patients, but all age groups share certain common features, such as a chronic and recurrent course of disease, pruritus, and a co-occurrence of atopic diseases in personal or family medical history [ 2 ]. Pruritus is not only a source of frustration for patients, but also an important cause of sleep disorders, and significantly impacts the quality of life both of patients and their families [ 6 , 7 ]. It is a fundamental symptom of AD and a primary component of most diagnostic criteria [ 8 ].…”