The Influence of Atopic Dermatitis on Health-Related Quality of Life in Bangladesh

Abstract

Atopic dermatitis (AD) is the foremost non-fatal skin-related disease that affects all age groups. Despite the growing prevalence of AD in low- and middle-income countries, its physiological consequences remain overlooked in countries like Bangladesh. Therefore, we aim to assess and characterize the influence of AD on the health-related quality of life (HRQoL) in Bangladeshi patients. A cross-sectional study comprising 184 eligible adults (83 men and 101 women; mean age, 33.46 ± 15.44 years) was conducted at the dermatology outpatient department of Shaheed Suhrawardy Medical College Hospital (a tertiary hospital in Dhaka, Bangladesh). AD was determined using the UK Working Party criteria. A structured questionnaire, Eczema Area and Severity Index (EASI), and Dermatology Life Quality Index (DLQI) were administered to obtain information on patient characteristics, AD severity, and HRQoL. The mean DLQI score for the entire sample was 11.29 ± 5.27 (range, 1–26), and 51.60% reported the disease greatly affected their lives. Bivariate analysis revealed significant differences in self-rated health measures of DLQI scores in terms of self-reported AD severity, overall health, and the EASI. In multivariable regression models adjusted for patient characteristics, the self-perceived severe AD group reported significantly higher DLQI scores (coefficient = 2.72; 95% confidence interval (CI) = 0.38–5.05; p = 0.022) than the mild group. Concurrently, we observed a substantial increase in the DLQI scores among patients with moderate and severe EASI scores (coefficient = 1.96, 95% CI = 0.08–3.92, p < 0.05 and coefficient = 4.35, 95% CI = 1.98–6.72, p < 0.001, respectively) than in those with mild EASI scores, suggesting that HRQoL was markedly influenced by greater AD severity. These findings highlight the need for a more patient-centric approach to the management of AD in order to alleviate patient suffering and, thereby, improve HRQoL.

Management and Outcome of Atopic Dermatitis in Primary Health Care in Low Income Countries : A Systematic Review

“…These results emphasize the necessity of managing AD with a more patient-centric strategy in order to reduce patient suffering and enhance HRQoL. 16 Results as reported by patients Clinical trial measures make ensuring that essential patient outcomes are the focus of efficacy assessments. Repeated assessments may provide a more accurate picture of the disease load and treatment efficacy than less frequent measures in relapsing-remitting disorders like eczema.…”

Measurement properties of quality‐of‐life outcome measures for children and adults with eczema: A systematic review update 2.0

“…In total, 12 articles reporting on 12 different PROMs in 45 single studies on measurement properties were analyzed 18,26,28–37 …”

“…In total, 12 articles reporting on 12 different PROMs in 45 single studies on measurement properties were analyzed. 18,26,[28][29][30][31][32][33][34][35][36][37] Relevant characteristics of the identified PROMs, such as number of items, recall period, response categories, and target population., are presented in Appendix S3. Relevant characteristics of the included study populations can be found in Appendix S4.…”