Higher self-reported severity of atopic dermatitis in adults is associated with poorer self-reported health-related quality of life in France, Germany, the UK and the USA

Background Better understanding of the relationship between atopic dermatitis (AD) severity and health-related quality of life (HRQoL) could help improve knowledge of a more effective treatment for people with AD. Objectives To assess the relationship between AD severity and HRQoL and perception of AD symptoms in adults with moderate-to-severe AD in Europe and the U.S.A. Methods Participants for this cross-sectional, internet-based survey were recruited from the larger population-based National Health and Wellness Survey. AD severity was measured by Patient-Oriented SCORing of AD. HRQoL was measured by the five-level EuroQol-5D, Dermatology Life Quality Index (DLQI) and Patient-Oriented Eczema Measure (POEM). Results Altogether, 1232 respondents were included: 1098 (89 center dot 1%) with moderate-to-severe AD [221 (20 center dot 1%) from France, 209 (19 center dot 0%) from Germany, 118 (10 center dot 7%) from the U.K. and 550 (50 center dot 1%) from the U.S.A.]. An additional 134 (10 center dot 9%) respondents with mild AD were included. Sociodemographic and clinical AD characteristics were similar between countries. In adults with moderate-to-severe AD, higher AD severity correlated with poorer HRQoL (Spearman's r = -0 center dot 38 and 0 center dot 61 for EQ-5D and DLQI, respectively; both P < 0 center dot 001). AD severity was positively correlated with POEM (Spearman's r = 0 center dot 51; P < 0 center dot 001). People with moderate-to-severe vs. those with mild AD had poorer health outcomes (EQ-5D, DLQI and POEM, P < 0 center dot 001 for all). These results were similar and consistent for the European and the U.S. populations separately. Conclusions Higher AD severity is associated with poorer HRQoL across Europe and the U.S.A. This is a burden for patients and may provide encouragement for more effective management of AD. What's already known about this topic? Atopic dermatitis (AD) is associated with a detrimental effect on health-related quality of life (HRQoL), including sleep disturbance, anxiety and depression. Limited data describing the relationship between different levels of AD severity and self-reported HRQoL have been published. What does this study add? There is a positive association between increasing AD severity (Patient-Oriented SCORing of AD) and decreasing HRQoL (EQ-5D and Dermatology Life Quality Index) and the perception of AD symptoms (Patient-Oriented Eczema Measure) from the patient's perspective. AD severity according to geographic locations was explored (France, Germany, the U.K., and the U.S.A.), showing that the decreasing HRQoL associated with increasing AD severity was quite consistent between the geographic locations.