Patient burden and quality of life in atopic dermatitis in US adults: A population-based cross-sectional study

Jonathan I. Silverberg, Joel M. Gelfand, David J. Margolis, Mark Boguniewicz, Luz Fonacier, Mitchell H. Grayson, Eric Simpson, Peck Y. Ong, Zelma C. Chiesa Fuxench

Research output: Contribution to journalArticle

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Abstract

Background: The patient burden and quality of life (QOL) impact of atopic dermatitis (AD) in the United States population is not well established. Objective: To elucidate the patient burden of AD in the US population. Methods: A cross-sectional, population-based study of 602 adults was performed. Atopic dermatitis was determined using modified UK Diagnostic Criteria for AD. Its severity was assessed using self-reported global AD severity, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Scoring AD (PO-SCORAD), PO-SCORAD-itch, and sleep. Quality of life was assessed using short-form (SF-)12 mental and physical health scores and Dermatology Life Quality Index (DLQI). Results: Adults with AD reported higher proportions of having only fair/poor overall health (25.8% vs. 15.8%), being somewhat/very dissatisfied with life (16.7% vs 11.4%), lower weighted mean (standard deviation [SD]) SF-12 mental (45.9 [9.9] vs 50.9 [9.2]) and physical health subscores (53.0 [2.5] vs 53.5 [2.3]) and higher DLQI (4.9 [6.5] vs 1.1 [2.8]). In multivariable regression models adjusting for sociodemographics and multiple comorbid health disorders, significant stepwise decreases by AD severity (self-reported, POEM, PO-SCORAD) of overall health, life satisfaction, SF-12 mental health, and increases of DLQI scores were seen. The SF-12 physical health scores were only associated with moderate AD. Concurrently, severe PO-SCORAD, POEM, or PO-SCORAD-itch was associated with very low mean SF-12 mental health (34.7) and high DLQI scores (24.7). Atopic dermatitis commonly limited lifestyle (51.3%), led to avoidance of social interaction (39.1%), and impacted activities (43.3%). The most burdensome AD symptoms were itch (54.4%), excessive dryness/scaling (19.6%), and red/inflamed skin (7.2%). Conclusion: These data support the heavy burden that AD places on patients, particularly those with moderate and severe AD.

Original languageEnglish (US)
Pages (from-to)340-347
Number of pages8
JournalAnnals of Allergy, Asthma and Immunology
Volume121
Issue number3
DOIs
StatePublished - Sep 1 2018

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Atopic Dermatitis
Cross-Sectional Studies
Quality of Life
Population
Dermatology
Eczema
Health
Mental Health
Interpersonal Relations
Life Style
Sleep

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

Cite this

Silverberg, J. I., Gelfand, J. M., Margolis, D. J., Boguniewicz, M., Fonacier, L., Grayson, M. H., ... Chiesa Fuxench, Z. C. (2018). Patient burden and quality of life in atopic dermatitis in US adults: A population-based cross-sectional study. Annals of Allergy, Asthma and Immunology, 121(3), 340-347. https://doi.org/10.1016/j.anai.2018.07.006

Patient burden and quality of life in atopic dermatitis in US adults : A population-based cross-sectional study. / Silverberg, Jonathan I.; Gelfand, Joel M.; Margolis, David J.; Boguniewicz, Mark; Fonacier, Luz; Grayson, Mitchell H.; Simpson, Eric; Ong, Peck Y.; Chiesa Fuxench, Zelma C.

In: Annals of Allergy, Asthma and Immunology, Vol. 121, No. 3, 01.09.2018, p. 340-347.

Research output: Contribution to journalArticle

Silverberg, JI, Gelfand, JM, Margolis, DJ, Boguniewicz, M, Fonacier, L, Grayson, MH, Simpson, E, Ong, PY & Chiesa Fuxench, ZC 2018, 'Patient burden and quality of life in atopic dermatitis in US adults: A population-based cross-sectional study', Annals of Allergy, Asthma and Immunology, vol. 121, no. 3, pp. 340-347. https://doi.org/10.1016/j.anai.2018.07.006
Silverberg, Jonathan I. ; Gelfand, Joel M. ; Margolis, David J. ; Boguniewicz, Mark ; Fonacier, Luz ; Grayson, Mitchell H. ; Simpson, Eric ; Ong, Peck Y. ; Chiesa Fuxench, Zelma C. / Patient burden and quality of life in atopic dermatitis in US adults : A population-based cross-sectional study. In: Annals of Allergy, Asthma and Immunology. 2018 ; Vol. 121, No. 3. pp. 340-347.
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N2 - Background: The patient burden and quality of life (QOL) impact of atopic dermatitis (AD) in the United States population is not well established. Objective: To elucidate the patient burden of AD in the US population. Methods: A cross-sectional, population-based study of 602 adults was performed. Atopic dermatitis was determined using modified UK Diagnostic Criteria for AD. Its severity was assessed using self-reported global AD severity, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Scoring AD (PO-SCORAD), PO-SCORAD-itch, and sleep. Quality of life was assessed using short-form (SF-)12 mental and physical health scores and Dermatology Life Quality Index (DLQI). Results: Adults with AD reported higher proportions of having only fair/poor overall health (25.8% vs. 15.8%), being somewhat/very dissatisfied with life (16.7% vs 11.4%), lower weighted mean (standard deviation [SD]) SF-12 mental (45.9 [9.9] vs 50.9 [9.2]) and physical health subscores (53.0 [2.5] vs 53.5 [2.3]) and higher DLQI (4.9 [6.5] vs 1.1 [2.8]). In multivariable regression models adjusting for sociodemographics and multiple comorbid health disorders, significant stepwise decreases by AD severity (self-reported, POEM, PO-SCORAD) of overall health, life satisfaction, SF-12 mental health, and increases of DLQI scores were seen. The SF-12 physical health scores were only associated with moderate AD. Concurrently, severe PO-SCORAD, POEM, or PO-SCORAD-itch was associated with very low mean SF-12 mental health (34.7) and high DLQI scores (24.7). Atopic dermatitis commonly limited lifestyle (51.3%), led to avoidance of social interaction (39.1%), and impacted activities (43.3%). The most burdensome AD symptoms were itch (54.4%), excessive dryness/scaling (19.6%), and red/inflamed skin (7.2%). Conclusion: These data support the heavy burden that AD places on patients, particularly those with moderate and severe AD.

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