The Quality of Life of Parents of Children with Atopic Dermatitis: Interpretation of PIQoL-AD Scores

Abstract

The PIQoL-AD has been used in several trials assessing quality of life (QoL) in parents of children with atopic dermatitis (AD), treated with pimecrolimus cream 1%. Secondary analysis of data from four trials (n = 621) was undertaken to help interpret the meaningfulness (significance) of the QoL results. A combination of anchor-based and distribution-based methods of interpreting instrument scores were employed. For each level on four AD severity indicators, mean PIQoL-AD scores and 95% confidence intervals were calculated. Low levels of association (r(s) range = 0.12-0.45) were observed between QoL and clinical indicators; confirming previous findings. When data from the different trials and time-points were combined clear patterns emerged indicating the clinical meaning of PIQoL-AD scores. Distribution-based statistics such as effect sizes, the standard error of measurement (SEM) and the standard error of difference (S(diff)) were also calculated. Despite a lack of consensus on how best to determine the meaningfulness of QoL scores, a large database of trial data was successfully used to link QoL scores to disease severity, aiding clinical interpretation of the former. Effect size, SEM and S(diff) values were consistent across the trials indicating that a change of 2 to 3 PIQoL-AD points over time could be considered meaningful. It is argued that it would be useful for clinicians to gain an understanding of the meaning of QoL scores through routine use of such measures in clinical practice.

Development of a questionnaire to assess the impact of atopic dermatitis on health-related quality of life of affected dogs and their owners

“…21,22 Questionnaires reflected those established and validated for the evaluation of QoL of children affected by AD and of their parents. 4,6,7,[10][11][12] The aim of the first questionnaire was to characterize the owner, accounting for the effects of sex and age, and to assess their link to the dog, and this was scored (owner-pet relation score = OPRS, see Appendix 1) from )8 to +8.…”

“…[1][2][3][4] Quality of life in humans has been defined by the World Health Organisation as 'the individuals' perception of their position in life, in the context of culture and value systems in which they live and in relation to their goals, expectations, standards and concerns', whereas healthrelated QoL (HRQoL) has been defined as the 'individuals' subjective perception of the impact of health status, including disease and treatment, on physical, psychological and social functioning'. 5 Several studies have been conducted to develop disease-specific questionnaires and assess QoL in parents of children with AD and in the children themselves.…”

“…5 Several studies have been conducted to develop disease-specific questionnaires and assess QoL in parents of children with AD and in the children themselves. 1,4,[6][7][8][9][10][11][12] In veterinary medicine, QoL is a concept that was initially developed to measure some aspects of nonphysical animal life and to guide decisions about aggressive treatment or euthanasia. [13][14][15][16][17][18][19] At this time, however, there is no accepted definition or methodology for its assessment in companion animals.…”

Children and adolescents’ health-related quality of life in relation to eczema, asthma and hay fever: results from a population-based cross-sectional study

“…Hay fever is a chronic inflammatory condition of the upper airways that can be characterised by rhinorrhea, nasal itching and obstruction and sneezing [9]. Lifetime prevalence estimates in children aged 7-12 years are 34.1% for eczema, 26.5% for hay fever and 28.4% for asthma [10] but there is substantial global variation in their prevalence [11][12][13]. All three conditions appear to share an underlying atopic diathesis, but their aetiology is considered to be multifactorial [14][15][16].…”

“…All three conditions appear to share an underlying atopic diathesis, but their aetiology is considered to be multifactorial [14][15][16]. The three conditions have been linked to decreases in health-related quality of life (HRQoL) in adults [17][18][19][20], children/adolescents [21][22][23][24][25] or parents of children [26,27].…”