Dataset Information

Burden of Atopic Dermatitis in Adults in Greece: Results from a Nationwide Survey.

ABSTRACT: The objective was to describe the AD burden in terms of quality of life (QoL), sleep, social life, work productivity, and resource utilization in Greece and assess the impact of disease severity. A nationwide cross-sectional survey was conducted. The questionnaire consisted of socioeconomic factors, medical history, AD screening, AD severity, QoL, sleep difficulties, social activities, and work productivity questions. AD was defined using the UK Working Party criteria (UKWP cohort) and a patient-reported AD diagnosis from a physician (Expert Diagnosis cohort). Self-reported moderate/severe AD was estimated using the Patient-Oriented Eczema Measure (POEM). In the UKWP cohort, the AD effect on QoL was moderate/extremely large in 84.3% of moderate/severe AD (vs. 55.7% in mild; p = 0.016), while in the Expert Diagnosis cohort, it was 72.2% (vs. 22.8%; p < 0.001). Disease severity was associated with a higher impact on sleep and social activities. Overall work impairment was high in both mild (32.7%) and moderate/severe (48.5%) AD of the UKWP cohort, while among the Expert Diagnosis cohort, it was significantly higher among those with moderate/severe (31.2%) versus mild AD (11.9%; p < 0.001). The AD burden in Greece is significant, especially for those in moderate/severe AD stages. Acknowledging this burden is the first step toward applying healthcare decisions that will benefit patients and the community.

SUBMITTER: Gregoriou S

PROVIDER: S-EPMC9410403 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Burden of Atopic Dermatitis in Adults in Greece: Results from a Nationwide Survey.

Gregoriou Stamatis S Stefanou Garyfallia G Kontodimas Stathis S Sfaelos Konstantinos K Zavali Maria M Vakirlis Efstratios E Kourlaba Georgia G

Journal of clinical medicine 20220816 16

The objective was to describe the AD burden in terms of quality of life (QoL), sleep, social life, work productivity, and resource utilization in Greece and assess the impact of disease severity. A nationwide cross-sectional survey was conducted. The questionnaire consisted of socioeconomic factors, medical history, AD screening, AD severity, QoL, sleep difficulties, social activities, and work productivity questions. AD was defined using the UK Working Party criteria (UKWP cohort) and a patient ...[more]

PMID: 36013017

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Project description:IntroductionAlthough previously regarded as a children's disease, it is clear that atopic dermatitis (AD) is also highly prevalent in adults. Because AD is not associated with mortality, it is usually neglected compared with other, fatal diseases. However, several studies have highlighted that AD burden is significant due to its substantial humanistic burden and psychosocial effects. This study aims to summarize and quantify the clinical, economic, and humanistic burden of AD in adults and adolescents.MethodsA systematic literature search was performed in PubMed, Scopus, Cochrane, Centre for Reviews and Dissemination (CRD), EconPapers, The Professional Society for Health Economics and Outcomes Research (ISPOR), The National Institute for Health and Care Excellence (NICE), and The Canadian Agency for Drugs and Technologies in Health (CADTH). Studies were included if they reported clinical, economic, or humanistic effects of AD on adults or adolescents, from January 2011 to December 2020. The Grading of Recommendations Assessment tool was used to assess risk of bias for the included studies. Regression models were used to explain the correlation between factors such as disease severity and quality of life (QoL).ResultsAmong 3400 identified records, 233 studies were included. Itch, depression, sleep disturbance, and anxiety were the most frequently reported parameters related to the clinical and humanistic burden of AD. The average utility value in studies not stratifying patients by severity was 0.779. The average direct cost of AD was 4411 USD, while the average indirect cost was 9068 USD annually.ConclusionsThe burden of AD is significant. The hidden disease burden is reflected in its high indirect costs and the psychological effect on QoL. The magnitude of the burden is affected by the severity level. The main limitation of this study is the heterogeneity of different studies in terms of data reporting, which led to the exclusion of potentially relevant data points from the summary statistics.

Project description:BackgroundAtopic dermatitis (AD) is associated with itch, skin inflammation and barrier disruption, and scratching, all of which may be associated with skin pain.ObjectiveTo characterize the patient burden of skin pain in AD.MethodsWe performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist.ResultsOverall, 305 patients (age range, 13-97 years) were included in the study, with 564 encounters. The cohort included 195 females (63.9%) and 193 whites (63.7%). The mean (SD) age at enrollment was 42.3 (18.1) years, and the mean (SD) age of patient-reported AD onset was 29.6 (31.9) years. At baseline, 144 patients (42.7%) reported skin pain in the past week, with 42 (13.8%) reporting severe or very severe pain. Twenty-four (16.8%) thought the skin pain was part of their itch, 16 (11.2%) from scratching, and 77 (72.0%) from both. Patients with skin pain were more likely to describe their itch using terms that resembled neuropathic pain. Prevalence of skin pain was increased in patients with vs without excoriations (72.6% vs 57.6%; χ2 test P = .02) but not other morphologic characteristics. Skin pain severity was most strongly correlated with the Patient-Oriented Eczema Measure (Spearman ρ = 0.54), followed by ItchyQOL (ρ = 0.52), 5-dimensions of itch scale (ρ = 0.47), Dermatology Life Quality Index (ρ = 0.45), numeric rating scale for itch (ρ = 0.43) and sleep (ρ = 0.36), Patient Health Questionnaire 9 (ρ = 0.36), patient-reported global AD severity (ρ = 0.34), Eczema Area and Severity Index (ρ = 0.23), and objective Scoring AD index (ρ = 0.20) (P < .001 for all). Patients with both severe itch and pain vs those with only one or neither symptom being severe had significant increases in all these measures.ConclusionSkin pain is a common and burdensome symptom in AD. Skin pain severity should be assessed with itch severity in AD patients and may be an important end point for monitoring treatment response.

Project description:IntroductionAtopic dermatitis (AD) is a chronic and relapsing inflammatory skin disease that negatively impacts overall health, quality of life (QoL), and work productivity. Prior studies on AD burden by severity have focused on moderate-to-severe disease. Here, we describe the clinical and humanistic burden of AD in Europe across all severity levels, including milder disease.MethodsData were analyzed from the 2017 National Health and Wellness Survey from adult respondents with AD in the EU-5 (France, Germany, Italy, Spain, and the UK). AD disease severity was defined based on self-reported assessments as "mild," "moderate," or "severe" and by Dermatology Life Quality Index (DLQI) severity bands. Self-reported outcomes for AD respondents by severity were assessed using propensity score matching. These outcomes included a wide range of selected medical/psychological comorbidities, overall QoL and functional status (EuroQol 5-Dimensions 5-Level and Short Form-36 version 2 questionnaires), and work productivity and activity impairment (Work Productivity and Activity Impairment questionnaire).ResultsIn total, 4208 respondents with AD (mild AD, 2862; moderate AD, 1177; severe AD, 169) and 4208 respondents without AD were included in this analysis. Results showed greater burden across severity levels compared with matched non-AD controls. A higher proportion of respondents with mild-to-moderate AD, defined by DLQI severity bands, reported atopic comorbidities (P < 0.05) and a wide range of cardiac, vascular, and metabolic comorbidities, including hypertension, high cholesterol, angina, and peripheral vascular disease (P < 0.005), compared with non-AD controls. Relative to potential impacts of various medical and psychological burdens, respondents with mild-to-moderate AD reported higher activity impairment than controls (P < 0.0001).ConclusionClinical and humanistic burden was observed in European respondents with AD compared with matched non-AD controls across severity levels, with burden evident even in milder disease, highlighting the importance of improving disease management in early stages of AD.

Dataset Information

Burden of Atopic Dermatitis in Adults in Greece: Results from a Nationwide Survey.

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Burden of Atopic Dermatitis in Adults in Greece: Results from a Nationwide Survey.

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