背景:虽然以前被认为是一种儿童疾病,很明显,特应性皮炎(AD)在成人中也非常普遍。因为AD与死亡率无关,与其他相比,它通常被忽略,致命的疾病。然而,几项研究强调,由于AD的重大人文负担和心理社会效应,AD负担非常重要.本研究旨在总结和量化临床,经济,成人和青少年AD的人文负担。
方法:在PubMed,Scopus,科克伦,审查和传播中心(CRD),EconPapers,卫生经济学和结果研究专业协会(ISPOR),国家健康与护理卓越研究所(NICE),和加拿大卫生药物和技术署(CADTH)。如果他们报告了临床研究,经济,或AD对成人或青少年的人文影响,从2011年1月到2020年12月。建议分级评估工具用于评估纳入研究的偏倚风险。回归模型用于解释疾病严重程度和生活质量(QoL)等因素之间的相关性。
结果:在3400条确定的记录中,包括233项研究。痒,抑郁症,睡眠障碍,和焦虑是与AD的临床和人文负担相关的最常报告的参数。在未按严重程度对患者进行分层的研究中,平均效用值为0.779。AD的平均直接成本为4411美元,而平均间接费用为每年9068美元。
结论:AD的负担是显著的。隐性疾病负担反映在其较高的间接成本和对QoL的心理影响上。负担的大小受严重程度的影响。这项研究的主要局限性是不同研究在数据报告方面的异质性,这导致从汇总统计数据中排除潜在相关的数据点。
特应性皮炎是儿童和成人中非常常见的皮肤病。该疾病是非致命的,但可能导致患者和家庭生活质量低下和生产力下降。尤其是在严重的情况下。因为特应性皮炎在儿童中比成人更常见,大多数已发表的研究旨在研究这种疾病对儿童的影响。特应性皮炎影响患者健康,生活质量,金融状态,和生产力。因此,我们的研究旨在研究和量化由临床负担中代表的疾病引起的负担,人文负担,和经济负担。我们进行了系统的文献综述,以确定所有相关研究,为负担提供具体价值。包括的研究提供了受特定症状影响的患者百分比的信息,治疗费用,由于疾病而导致生产力损失的天数,特应性皮炎患者或其护理人员的生活质量问卷结果。我们分析了所有相关研究的数据,以计算平均值并量化负担。我们的研究结果应有助于医疗保健部门的决策者了解疾病对成人和青少年的实际影响,并根据每种疾病的具体负担重新安排治疗不同疾病的优先事项。
BACKGROUND: Although 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.
METHODS: A 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).
RESULTS: Among 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.
CONCLUSIONS: The 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.
Atopic dermatitis is a very common skin disease among children and adults. The disease is nonfatal but may lead to patients and families having a low quality of life and decreased productivity, especially in its severe state. Because atopic dermatitis is more common in children than adults, most published research is directed to studying the effect of the disease on children. Atopic dermatitis affects patients’ health, quality of life, financial state, and productivity. Therefore, our study aims to study and quantify the burden caused by the disease represented in the clinical burden, humanistic burden, and economic burden. We conducted a systematic literature review to determine all relevant studies providing specific values for the burden. The studies included are those providing information on the percentage of patients affected by specific symptoms, costs paid for treatment, number of days of productivity lost due to the disease, and quality-of-life questionnaire results for patients with atopic dermatitis or their caregivers. We analyzed the data from all relevant studies to calculate average values and quantify the burden. The results of our study should help healthcare sector decision-makers in understanding the real effect of the disease on adults and adolescents and rearrange their priorities for treating different diseases based on the specific burden of each disease.