MedWire News: Poor quality of life (QoL) in patients with psoriasis is associated with greater use of healthcare resources and employment disadvantages independently of disease severity, research suggests.
"From the patients perspective, psoriasis can have significant adverse effects on health-related QoL," note Reiko Sato (Pfizer, Collegeville, Pennsylvania, USA) and colleagues.
"To improve their QoL, patients with psoriasis are likely to seek better treatment, which might result in increased psoriasis-related healthcare resource utilization (HCRU)."
To investigate these potential associations further, the team recruited 897 patients with plaque psoriasis in five European countries.
The patients were divided into two groups: 743 patients with scores of 10 or below out of a possible 30 on the Dermatology Life Quality Index (DLQI; better QoL) and 154 patients with scores above 10 (poor QoL).
Patients with poor QoL had a significantly higher mean number of visits to their primary dermatologist in the past 12 months compared with patients with better QoL, at an average of 7.89 versus 5.37. They also had a higher number of hospitalizations due to psoriasis in the past 12 months, at respective means of 0.32 versus 0.90.
The researchers acknowledge in the journal Clinical and Experimental Dermatology that patients with a poor QoL of had greater disease severity, as measured by affected body surface area (BSA), at 29.17% versus 17.21% among patients with better QoL.
However, on Pearson's analysis the correlation between affected BSA and DLQI score was found to be low.
Also, significant differences in HCRU between patients with poor and better QoL remained even after adjusting for age, gender, and body surface area.
"This implies that measuring clinical severity of skin lesions does not fully capture the effect of the disease on patient QoL, and may be explained by the influence of multiple factors on QoL outside the sphere of traditional disease severity measures," say Sato et al.
The investigators also analyzed the patients' responses to five employment-related questions, which showed that a significantly greater proportion of people with poor QoL than with better QoL were experiencing problems with employment, including obtaining jobs and promotions. Again, this significant difference was independent of age, gender, and affected BSA.
They conclude: "Successfully treating patients with psoriasis to improve their QoL may reduce psoriasis-related HCRU and lessen employment disadvantages."
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