Quality of Life in Adults with Atopic Dermatitis in Relation to Disease Severity: Nationwide Data in Japan.

IF 3.5 3区医学 Q1 DERMATOLOGY Dermatology and Therapy Pub Date : 2025-01-15 DOI:10.1007/s13555-024-01333-7

Hiroyuki Murota, Takeshi Nakahara, Shinichi Noto, Miyuki Matsukawa, Hiroe Takeda, Rikiya Toda

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Abstract

Introduction: The impact of atopic dermatitis (AD) on daily life and different levels of quality of life (QOL) according to AD severity has not been fully elucidated. This study aimed to assess QOL in relation to the AD severity in Japan.

Methods: This observational study used anonymized data of health insurance association members and their families registered to a mobile health app. The QOL measures included the Dermatology Life Quality Index (DLQI), EuroQol five-dimensional five-level descriptive system (EQ-5D-5L), Work Productivity and Activity Impairment (WPAI), and sleep disturbance Numerical Rating Scale (NRS). The data were assessed according to AD severity: the Patient-Oriented Eczema Measure (POEM: 0-2, "clear/almost clear"; 3-7, "mild"; 8-16, "moderate"; 17-24, "severe"; 25-28, "very severe"); and itch NRS (0-10).

Results: Of 1507 adults with AD symptoms or undergoing treatments, 882 were identified with AD diagnosis records. Of those, 229 (26.0%), 242 (27.4%), 273 (31.0%), and 138 (15.6%) were included in the clear/almost clear, mild, moderate, and severe/very severe POEM groups, with mean ± standard deviation DLQI scores of 2.0 ± 2.7, 3.6 ± 3.3, 6.1 ± 4.4, and 10.4 ± 5.7, respectively. Higher DLQI scores were observed with increasing POEM severity and itch NRS (Spearman's rank correlation coefficient 0.629 and 0.615, respectively). EQ-5D-5L scores slightly lowered with increasing POEM severity, whereas WPAI percentage slightly increased. Sleep disturbance NRS increased with increasing AD severity in terms of POEM and itch NRS. Adults identified with AD diagnosis records (n = 882) yielded higher WPAI percentages than those without (n = 1204) in all four domains (Wilcoxon rank sum test, p < 0.001 for all).

Conclusion: This study, using real-world data in Japan, presented valuable data on the relationship between AD severity and various aspects of QOL. The data suggested greater QOL impairment with increasing AD severity; even at lower severity levels, QOL was impacted to some extent. The results highlight the need for careful consideration during clinical practice.

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成人特应性皮炎患者的生活质量与疾病严重程度的关系：日本全国数据

引言：特应性皮炎（AD）对日常生活和不同程度的生活质量（QOL）的影响尚未完全阐明。本研究旨在评估生活质量与日本AD严重程度的关系。方法：本观察性研究使用在移动健康应用程序中注册的健康保险协会会员及其家属的匿名数据。生活质量测量包括皮肤病生活质量指数（DLQI）、EuroQol五维五级描述系统（iq - 5d - 5l）、工作效率和活动障碍（WPAI）和睡眠障碍数值评定量表（NRS）。根据AD的严重程度对数据进行评估：以患者为导向的湿疹测量(POEM: 0-2，“清楚/几乎清楚”；3 - 7,“温和的”;8-16“温和”;17-24,“严重”;25-28，“非常严重”)；瘙痒NRS（0-10）。结果：在1507名有AD症状或正在接受治疗的成年人中，882人有AD诊断记录。其中，清晰/几乎清晰、轻度、中度、重度/极重度POEM组229例（26.0%）、242例（27.4%）、273例（31.0%）、138例（15.6%），DLQI评分平均±标准差分别为2.0±2.7、3.6±3.3、6.1±4.4、10.4±5.7。DLQI评分越高，POEM严重程度越高，瘙痒NRS越高（Spearman等级相关系数分别为0.629和0.615）。EQ-5D-5L评分随POEM严重程度的增加而略有降低，而WPAI百分比略有增加。睡眠障碍NRS随AD严重程度的增加而增加，如POEM和瘙痒NRS。在所有四个领域中，有AD诊断记录的成年人（n = 882）的WPAI百分比高于没有AD诊断记录的成年人（n = 1204）（Wilcoxon秩和检验，p）。结论：本研究使用日本的真实数据，提供了AD严重程度与生活质量各方面之间关系的有价值数据。数据显示，随着AD严重程度的增加，生活质量的损害越大；即使在较低的严重程度下，生活质量也受到一定程度的影响。结果强调在临床实践中需要仔细考虑。

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来源期刊

Dermatology and Therapy Medicine-Dermatology

CiteScore

6.00

自引率

8.80%

发文量

187

审稿时长

6 weeks

期刊介绍： Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.