Impact of atopic dermatitis on health-related quality of life and productivity in adults in the United States: An analysis using the National Health and Wellness Survey

J Am Acad Dermatol. 2017 Aug;77(2):274-279.e3. doi: 10.1016/j.jaad.2017.04.019. Epub 2017 Jun 9.


Background: Given its public health impact, there is need for broad and representative data on the humanistic burden of atopic dermatitis (AD).

Objective: To establish the humanistic burden of AD in US adults.

Methods: Data were from the 2013 US National Health and Wellness Survey; AD self-reports were propensity-matched with non-AD controls and with psoriasis controls. Bivariate analyses were conducted on burden outcomes between the AD and control groups.

Results: Demographics and baseline characteristics were comparable between matched groups. Subjects with AD (n = 349) versus non-AD controls (n = 698) had significantly higher rates of anxiety, depression, and sleep disorders (29.8%, 31.2%, and 33.2% vs 16.1%, 17.3%, and 19.2%, respectively [all P < .001]); a lower Short Form-36 v2 mental component summary score (44.5 vs 48.0, respectively [P < .001]); a lower physical component summary score (47.6 vs 49.5, respectively [P = .004]), and lower health utilities (0.67 vs 0.72, respectively [P < .001]) in addition to a higher work absenteeism rate (9.9% vs 3.6%, respectively [P < .001]) and activity impairment rate (33.6% vs 25.2%, respectively [P < .001]). Subjects with AD and psoriasis controls (n = 260 each) showed similar impairment in health-related quality of life and productivity.

Limitations: Data were self-reported.

Conclusion: AD is associated with a substantial humanistic burden that is similar in magnitude to that of psoriasis, which is also recognized for its debilitating symptoms, indicating the need for more effective treatments for AD.

Keywords: atopic dermatitis; burden of dermatitis; burden of disease; eczema; mental health; mood disorder; patient-reported outcomes; productivity; quality of life; sleep disorder.

MeSH terms

  • Adult
  • Anxiety / epidemiology*
  • Case-Control Studies
  • Comorbidity
  • Cost of Illness*
  • Cross-Sectional Studies
  • Depression / epidemiology*
  • Dermatitis, Atopic / epidemiology*
  • Dermatitis, Atopic / psychology
  • Efficiency*
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Quality of Life*
  • Severity of Illness Index
  • Sick Leave / statistics & numerical data
  • Sleep Wake Disorders / epidemiology*
  • United States / epidemiology