Decreased professional performance and quality of life in patients withmoderate-to-severe atopic eczema - Results from the German atopic eczema registry TREATgermany

Background: Clinical registries may provide high quality evidence on the use and effectiveness of therapeutic interventions under real-life conditions. Adults with moderate-to-severe AD are enrolled into TREATgermany and prospectively followed over at least 2 years. The paper analyses the association between dermatological quality of life and work limitations. Materials and methods: Treatment modalities and a broad set of physician and patient reported outcome measures are documented using validated instruments to assess clinical disease severity (EASI, objective SCORAD), quality of life (DLQI), symptoms (POEM), global disease severity, as well as patient satisfaction and work limitations including presentism (WLQ). From 06/2016 until 12/2017, 241 individuals (mean age 43 +/- 15 years, 38.6% female) were enrolled at 19 recruitment centers. 69% of them were currently employed. Results: Employed persons had DLQI and WLQ scores of 10.4 +/- 6.9 points and 17.7 +/- 18.1%, respectively. Mean presentism was substantial accounting for 9.2%. With coefficients of 0.39 and 0.33 WLQ and presentism scores significantly correlate with DLQI (p < 0.000). Bootstrapped regression models showed that the limitations in coping with work requirements increase by 1.7% as DLQI increases by one point. Lower quality of life due to AD is most strongly associated with limitations in the area of physical and performance requirements in general. Presentism decreases by 0.5% as DLQI increases by one point. Conclusion: Moderate-to-severe AD has substantial adverse economic impact with mean productivity loss of patients of almost 10%. Future analyses from TREATgermany will address the impact of innovative treatment modalities on quality of life and work productivity of patients with moderate-to-severe AD.