背景:特应性皮炎(AD)的负担很大,对生活质量(QoL)有重大影响。这项横断面研究旨在确定AD的负担,它对QoL的影响,以及相关成本。
方法:中重度AD患者来自八个地区,即香港,印度,Japan,中国大陆,新加坡,韩国,台湾,和泰国。在进行筛查并获得知情同意书后,符合条件的参与者被要求提供对其AD症状的反应,严重程度,治疗,以及通过在线调查的自付费用。使用EQ-5D-5L和皮肤病生活质量指数(DLQI)评估QoL,而生产率损失是使用工作生产率和活动损害(WPAI)问卷量化的。使用描述性统计分析来自完成的提交的数据。该研究由每个地区的机构审查委员会审查。
结果:入选患者的中位年龄(N=1103)为41.0岁(四分位数间距,IQR16.0)。大多数患者报告说,他们的头/颈部,树干,上肢,和下肢在耀斑时受到影响。经常使用局部(74.2%)和口服类固醇(58.7%)来管理AD。常见的特应性合并症为过敏性荨麻疹(64.2%),过敏性鼻炎(61.8%),和过敏性结膜炎(51.5%)。DLQI中位数为13.0(IQR11.0),而EQ-5D-5L(基于中国价值集)评分中位数为0.8(IQR0.4);87.2%和77.2%的患者在EQ-5D-5L领域报告了疼痛/不适和焦虑/抑郁,分别。与AD相关的年总费用中位数为每位患者10,128.52美元(IQR12,963.26美元),间接成本是最大的组成部分。WPAI的结果表明,出勤是生产力损失的主要原因。
结论:这项跨国调查研究表明,在患有中度至重度AD的亚洲成年患者中,AD与严重的QoL损害和经济负担相关。为了减轻AD的负担,临床医生应该更积极地管理其他伴随的疾病,包括心理问题,并主张增加AD治疗的报销。
BACKGROUND: The burden of atopic dermatitis (AD) is significant, with a substantial impact on quality of life (QoL). This cross-sectional study aimed to ascertain the burden of AD, its impact on QoL, and associated costs.
METHODS: Patients with moderate-to-severe AD were enrolled from eight territories, namely Hong Kong, India, Japan, Mainland China, Singapore, South Korea, Taiwan, and Thailand. After screening was performed and informed consent was obtained, eligible participants were asked to provide responses on their AD symptoms, severity, treatment, and out-of-pocket costs via an online survey. QoL was assessed using EQ-5D-5L and Dermatology Life Quality Index (DLQI), while productivity loss was quantified using the Work Productivity and Activity Impairment (WPAI) questionnaire. Data from completed submissions were analyzed using descriptive statistics. The study was reviewed by the institutional review board in each territory.
RESULTS: Median age of enrolled patients (N = 1103) was 41.0 years (interquartile range, IQR 16.0). The majority of patients reported that their head/neck, trunk, upper limbs, and lower limbs were affected during a flare. Topical (74.2%) and oral steroids (58.7%) were frequently prescribed to manage AD. Common atopic comorbidities were allergic urticaria (64.2%), allergic rhinitis (61.8%), and allergic conjunctivitis (51.5%). Median DLQI score was 13.0 (IQR 11.0), while median EQ-5D-5L (based on China value set) score was 0.8 (IQR 0.4); 87.2% and 77.2% of patients reported pain/discomfort and anxiety/depression on the EQ-5D-5L domains, respectively. Median total annual costs associated with AD were USD 10,128.52 (IQR 12,963.26) per patient, with indirect costs being the largest component. Findings from WPAI indicated that presenteeism is a major contributor to productivity loss.
CONCLUSIONS: This multinational survey study showed that AD is associated with substantial QoL impairment and economic burden among Asian adult patients with moderate-to-severe AD. To alleviate burden of AD, clinicians should be more proactive in managing other concomitant conditions including psychological issues, and advocate for increased reimbursement for AD treatments.