Eczema Quality of Life (QoL)
Eczema can profoundly impact Quality of Life (QoL) for patients and their family.
What is Quality-of-Life (QoL)? It’s what matters most to the patient. It’s the patient’s perception of the disease, how it affects their mental, physical, social, and romantic state. It represents how the patient feels about the quality, effectiveness, and aggressiveness of their treatment. It is how the patient feels about the quality of care they are receiving. It is also whether their healthcare provider is sympathetic and understanding to the patient’s needs.
Despite the fact that approximately 10% to 20% of the world's population develops atopic dermatitis, public awareness and acceptance of the disorder appears lacking. The severity of symptoms which many endure remains a privately held experience. 3rd party awareness groups and the latest research promote awareness for this massive group of sufferers and the latest medical technologies which can help them. Many sufferers attempt to treat their disease themselves, addressing only certain aspects of their disease. Dermatologists are ideally suited to provide a comprehensive treatment program which includes the latest medical technologies.
The International Study Of Life with ATopic Eczema survery (ISOLATE) investigated the impact of eczema on patients' and caregivers' Quality of Life and included over 2,000 people from eight countries. The survey examined patient and caregiver perception of Quality of Life and their acceptance and use of pharmaceuticals to control the disease. The survey did not appear to examine patients' overall treatment programs including routines to improve skin barrier function, use of ultraviolet phototherapy, and modification of diet and environment. However, this massive patient and caregiver population clearly indicated that eczema in their life had a detrimental impact on Quality of Life, and demonstrated an enormous unmet clinical need.
Itching is one of the most troublesome symptoms of eczema. It affects almost every aspect of a sufferer’s life and reduces quality of life. Eczema impacts the physical and emotional boundaries and the evolving body image. Its effect on sleep can affect mood and performance during the day. In general, the greater the apparent severity of eczema, the greater the physical, emotional, and social impact.
Quality of Life (QoL) in Adult Eczema Sufferers
Due to the chronic and relapsing nature of eczema, it has been shown in numerous studies the significant impact the disease has on a patient's life. It is found that social interactions are hindered, self-esteem is lowered, and sleep disturbances are more common.
The Dermatology Life Quality Index (DLQI), is a self-administered general dermatology quality of life instrument, originally developed and published in a dermatology clinic at University Hospital of Wales. It is used widely internationally to assess a patient's quality of life with a variety of skin conditions, including eczema. View a copy of the DLQI.
In a European study using the Dermatology Life Quality Index (DLQI) to assess the effect of severe atopic eczema on the quality of life in 92 adult patients, it was found that adults with severe atopic eczema considered that having diabetes or hypertension would be better than having eczema. Eighty percent of these patients reported that their atopic dermatitis affected family life and 57% reported that the disease hindered sexual relationships. Additionally, 32% reported having lost income because of their eczema. Finlay; JEADV; June 2006
Adults with eczema can enhance their quality of life by:
- Adopting a regular skincare regimen
- Being mindful of irritants that affect their skin
- Developing stress and relaxation techniques to calm/ decrease flaring
- Developing a support system with family and healthcare providers
- Finding more effective, safer treatment options to reduce or eliminate symptoms
Quality of Life (QoL) in Children with Eczema
When a child has eczema, the entire family can feel it's effects. One helpful but difficult coping strategy includes distracting the child and providing activities that keep hands busy to avoid scratching and irritation. Other issues associated with children include social and emotional stress associated with changes in appearance caused by eczema. The child may face difficulty in school or with social relationships and may need additional support and encouragement from family members.
According to research published by the British Journal of Dermatology, children with serious skin conditions such as eczema feel their quality of life is impaired to the same extent as those with chronic illnesses such as epilepsy, renal disease and diabetes. Children with eczema resulted in a 31% impairment in their quality of life score. From the parent's perspective, eczema was the biggest skin problem at 33% decrease in their quality of life score. Imagine this effect when the most impactful ranking disease, cerebral palsy, ranked at 38% decrease in Quality of Life (QoL) score. Eczema was also ranked 1% lower in quality of life score than cystic fibrosis, (cystic fibrosis ranking at a 32% decrease in QoL).
Being able to suppress eczema outbreaks for longer periods of time will help to improve both children and adults' Quality of Life (QoL), physically, emotionally, and socially.