Beyond the quality of life: A call for patients’ own willingness to pay in chronic skin disease to assess psychosocial burden: A multi-center, cross-sectional prospective survey

BACKGROUND Rosacea is a chronic inflammatory dermatosis with facial skin involved, leading to physical and emotional problems, which greatly affected quality of life (QoL) of patients. Dermatology Life Quality Index (DLQI) and willingness to pay (WTP) are well-established instruments assessing the health-related quality of life (HRQoL), while very few studies have been focused on this topic about rosacea in China. OBJECTIVE To investigate HRQoL in Chinese rosacea patients assessed by DLQI and WTP and investigate potential predictors for patients with HRQoL severely affected. METHODS This cross-sectional study was conducted on 973 patients with rosacea. Sociodemographic data, clinical features and DLQI were collected, and WTP was assessed by three standardized items. Multivariable logistic analysis was performed to investigate independent factors influencing QoL. RESULTS 921 questionnaires were accomplished by participants. The mean DLQI score was 11.6 (median 11). Patients were willing to pay an average of $1050.2 or € 896.2 (median $431.4 or € 368.1) for complete cure. 33.3% would like to pay more than 20% of their monthly income to achieve sustainable control. There were positive correlations between WTP with DLQI (P < .05). DLQI could be independently impacted by age (21-30 and 31-40, OR = 3.242 and 3.617, respectively), the occupational requirement of appearance (high, OR = 4.410), disease duration (< 2 years, OR = 1.582), oedema (OR = 1.844) and severity of flushing, burning, stinging and pruritus (severe, OR = 2.003, 1.981, 2.491, 2.249, respectively). There were no significant associations between WTP and most of the clinical factors. CONCLUSIONS The QoL was negatively affected and should not be ignored among rosacea patients in China. Patients aged 21-40y, having occupational requirement of appearance, with the disease duration less than 2 years, and suffering severe flushing and related symptoms were more likely to have severe or very severe limitation of QoL.

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Chronic skin disease and levels of physical activity in 17 777 Spanish adults: a cross‐sectional study

Clinical and Experimental Dermatology ◽

10.1111/ced.14443 ◽

2020 ◽

Author(s):

L. Jacob ◽

G. F. López‐Sánchez ◽

A. Koyanagi ◽

N. Veronese ◽

J. Vioque‐López ◽

...

Keyword(s):

Physical Activity ◽

Skin Disease ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Chronic Skin ◽

Chronic Skin Disease

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Adherence to Guideline-Oriented Preventive Measures in Patients with Atopic Dermatitis in Germany

Dermatology ◽

10.1159/000517019 ◽

2021 ◽

pp. 1-6

Author(s):

Birgit-Christiane Zyriax ◽

Matthias Augustin ◽

Finn Abeck ◽

Nicole Mohr ◽

Natalia Kirsten ◽

...

Keyword(s):

Quality Of Life ◽

Atopic Dermatitis ◽

Skin Disease ◽

Preventive Measures ◽

Routine Care ◽

The Self ◽

Evidence Based ◽

Relaxation Techniques ◽

Cross Sectional

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that is often associated with comorbidities and quality of life losses. The implementation of evidence-based preventive measures strengthens patient participation and offers the potential to improve quality of care for AD. Objectives: To assess adherence to guideline-oriented preventive measures in adult patients with AD in dermatological routine care in Germany. Methods: The self-responsible application of preventive measures, clinical features, pruritus, disease severity, and duration of disease as well as skin disease-related quality of life were assessed in two independent cross-sectional studies in 2010 and 2017–2019. Results: Between 2017 and 2019, 706 patients (55.8% female, mean age 41 years) were recruited in a comparable way to the survey in 2010 with 1,678 patients (60.5% female, mean age 38 years). Regular skin care was applied by 99.5% (2010: 94.9%), 90.9% avoided skin irritants (2010: 84.6%), and 80.2% (2010: 61.6%) did not smoke at home. Relaxation techniques were applied by 44.4% (2010: 29.9%). Advice on self-help measures was taken by 36.4% (2010: 27.1%) and 29.2% (2010: 15.4%) attended AD patient education courses. All six preventive measures categorized as obligatory were performed by 13.9% of the patients (2010: 6.7%). Predictors for the number of obligatory preventive measures applied were a high level of education, a longer disease duration, and a lower quality of life. Conclusions: Although the self-reported use of evidence-based preventive measures in the 2017–2019 study appears to be more frequent than in 2010, important measures are still insufficiently established. Hence, more implementation, including education, is needed to increase the use of guideline-oriented preventive measures.

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Psychosocial impact of skin diseases: A population-based study

PLoS ONE ◽

10.1371/journal.pone.0244765 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244765

Author(s):

Yik Weng Yew ◽

Amanda Hui Yu Kuan ◽

Lixia Ge ◽

Chun Wei Yap ◽

Bee Hoon Heng

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Disease Severity ◽

Social Isolation ◽

Skin Disease ◽

Skin Diseases ◽

Community Dwelling ◽

Psychosocial Burden ◽

Loneliness Scale

Background While it is well established that skin disease places significant psychosocial burden on a patient’s wellbeing, its effects have rarely been examined in Asian populations. Objective Evaluate the psychosocial burden of skin disease among community-dwelling adults in Singapore. Methods This cross-sectional study included 1510 participants interviewed on their history of thirteen skin diseases. The Patient Health Questionnaire (PHQ-9), Lubben Social Network Scale-6 (LSNS-6), University of California Los Angeles (UCLA) Loneliness Scale, and European Quality of Life-5 Dimensions- 5 Level (EQ-5D-5L) were used as measures for depressive symptoms, social isolation, loneliness and quality of life respectively. Multiple linear regression analysis was used to examine the association of skin diseases with each of the four measured outcomes. Results Participants with skin diseases reported significantly higher PHQ-9 and UCLA Loneliness scale scores, and lower LSNS-6 and EQ-5D-5L scores when compared to their healthy counterparts. The presence of skin disease was positively associated with depressive symptoms (B = 0.40, SE = 0.11), and negatively associated with quality of life (B = -0.03, SE = 0.01). As disease severity was not evaluated in this study, we were unable to ascertain the associations between disease severity and measured outcomes. Conclusion Participants with skin diseases were more likely to have depressive symptoms, social isolation, loneliness and lower quality of life. Unemployed, single and elderly patients were at higher risk of developing depressive symptoms. More emphasis should be placed on the psychosocial aspect of care to reduce the burden of skin disease. Some considerations include monitoring patients for mood-related changes and implementing early psychosocial interventions.

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Psychosocial burden of lichen planus pigmentosus is similar to vitiligo, but greater than melasma: A cross-sectional study from a tertiary-care center in north India

Indian Journal of Dermatology Venereology and Leprology ◽

10.25259/ijdvl_877_19 ◽

2021 ◽

Vol 87 ◽

pp. 341-347

Author(s):

Vishal Gupta ◽

Deepika Yadav ◽

Sujata Satapathy ◽

Ashish Upadhyay ◽

Soniya Mahajan ◽

...

Keyword(s):

Quality Of Life ◽

Lichen Planus ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

North India ◽

Sectional Study ◽

Psychosocial Burden ◽

Cross Sectional

Background: Lichen planus pigmentosus can have a negative impact on the quality of life; however, this has not been studied in detail. Objectives: To study the quality of life in patients with lichen planus pigmentosus and compare it with patients with vitiligo and melasma. Methods: This was a cross-sectional study conducted in a tertiary-care center in north India from January 2018 to May 2019. Patients ≥ 18 years of age with lichen planus pigmentosus (n = 125), vitiligo (n = 113) and melasma (n = 121) completed the Dermatology Life Quality Index (DLQI) questionnaire and answered a global question on the effect of disease on their lives. In addition, patients with vitiligo completed the Vitiligo Impact Scale (VIS)-22 questionnaire, while those with lichen planus pigmentosus and melasma filled a modified version of VIS-22. Results: The mean DLQI scores in patients with lichen planus pigmentosus, vitiligo and melasma were 10.9 ± 5.95, 9.73 ± 6.51 and 8.39 ± 5.92, respectively, the difference being statistically significant only between lichen planus pigmentosus and melasma (P < 0.001). The corresponding mean modified VIS-22/VIS-22 scores were 26.82 ± 11.89, 25.82 ± 14.03 and 18.87 ± 11.84, respectively. This difference was statistically significant between lichen planus pigmentosus and melasma, and between vitiligo and melasma (P < 0.001 for both). As compared to vitiligo, patients with lichen planus pigmentosus had a significantly greater impact on “symptoms and feelings” domain (P < 0.001) on DLQI, and on “social interactions” (P = 0.02) and “depression” (P = 0.04) domains on VIS-22. As compared to melasma, patients with lichen planus pigmentosus had significantly higher scores for “symptoms and feelings,” “daily activities,” “leisure” and “work and school” domains of DLQI, and all domains of VIS-22. Female gender was more associated with impairment in quality of life in patients with lichen planus pigmentosus, while lower education, marriage, younger age and increasing disease duration showed a directional trend. Limitations: Use of DLQI and modified version of VIS-22 scales in the absence of a pigmentary disease-specific quality-of-life instrument. Conclusion: Patients with lichen planus pigmentosus have a significantly impaired quality of life. The psychosocial burden of lichen planus pigmentosus is quantitatively similar to that of vitiligo, but significantly greater than melasma.

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Quality of life in Montenegrin pupils with acne

PLoS ONE ◽

10.1371/journal.pone.0250155 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250155

Author(s):

Milena Ražnatović Đurović ◽

Milica Đurović ◽

Janko Janković ◽

Slavenka Janković

Keyword(s):

Quality Of Life ◽

Skin Disease ◽

Skin Diseases ◽

Life Quality ◽

Total Sample ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Common Skin ◽

The Mean

Background Acne is a common skin disease that can affect a person’s quality of life (QoL), self-esteem, and mood in an adverse manner. The aim of the current study was to assess QoL among Montenegrin pupils with acne. Methods This cross-sectional survey was conducted over October and November 2020 in four randomly selected secondary schools in Podgorica, Montenegro. All 500 pupils were asked to fill in a short questionnaire which included questions on age, sex, presence of acne, and for those with acne their duration and location, visits to doctors, presence of any other coexisting skin disease, and family history of acne. Only pupils who self-reported acne were asked to complete the Children’s Dermatology Life Quality Index (CDLQI) and the Cardiff Acne Disability Index (CADI). Results Self reported acne were presented in 49.8% (249/500) of all pupils. The mean CDLQI score of the total sample was 4.27 ± 5.13. Overall, the CDLQI domains that were most affected by acne were symptoms and feelings (mean score 1.49 ± 1.43), leisure (mean score 0.94 ± 1.72), and treatment (0.66 ± 0.79). The mean total CADI score was 3.53 ± 3.11 which was higher in girls (4.07 ± 3.11) than in boys (2.90 ± 3.00). There was good correlation between the two questionnaires (Rho = 0.76; P < 0.01). According to multiple linear regressions, higher overall CDLQI score was found in pupils with acne who reported other skin diseases, while girls, pupils who reported both acne on face and back, and who had any concomitant skin disease had higher CADI total score. Conclusions Acne affects QoL of young adolescents in Montenegro with greater impact in girls. Our findings should point out the importance of timely diagnosis, treatment, and education of adolescents with acne.

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