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. 2015 Dec;8(6):551-8.
doi: 10.1007/s40271-015-0145-9.

The Impact of Chronic Urticaria from the Patient's Perspective: A Survey in Five European Countries

Maria-Magdalena Balp  1 , Jeffrey Vietri  2 , Haijun Tian  3 , Gina Isherwood  4
Affiliations

The Impact of Chronic Urticaria from the Patient's Perspective: A Survey in Five European Countries

Maria-Magdalena Balp et al. Patient. 2015 Dec.

Abstract

Background: Chronic spontaneous urticaria (CSU) is associated with considerable burden, but data from European patients are limited.

Methods: This study is a retrospective, cross-sectional analysis of National Health and Wellness Survey data from the five largest EU countries (5EU: France, Germany, Italy, Spain, and the UK) collected between 2010 and 2013. Burden of disease for patients with CSU was estimated by comparing individuals currently treated for chronic urticaria (proxy CSU cases) with controls selected from respondents without chronic urticaria. Matching and regression models were used to quantify the impact of chronic urticaria on health-related quality of life, self-reported psychological complaints, work and activity impairment, and healthcare use.

Results: The sample included 175,923 respondents. Prevalence of diagnosed chronic urticaria was 0.5 and 0.2% were treating the condition with a prescription. Cases (N = 369) had substantially lower (worse) regression-adjusted mean Mental Component Summary (40.2 vs. 45.4), Physical Component Summary (44.6 vs. 49.9), and SF-6D health utility scores (0.63 vs. 0.71; all p < 0.001) relative to controls (N = 1476), differences that exceed accepted minimally important differences for these measures. Depression, anxiety, and sleep difficulties were approximately twice as prevalent among those currently receiving treatment for chronic urticaria (all p < 0.001). Cases also had elevated presenteeism (31 vs. 17%), overall work impairment (37 vs. 20%), and impairment in non-work activities (42 vs. 26%; all p < 0.01) relative to controls. Physician visits (9.1 vs. 4.9), emergency room visits (0.8 vs. 0.3), and hospitalizations (0.3 vs. 0.2) were more frequent than in controls (all p < 0.01).

Conclusions: This research adds to the existing evidence showing significant burden of CSU.

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Figures

Fig. 1
Fig. 1
Health-related quality of life among those currently treated for chronic urticaria relative to controls. a and b present matched comparisons before and after regression adjustment, respectively. Variables used in matching were year of survey, country, age, and sex. Covariates included cigarette smoking, body mass index category, and Charlson comorbidity index score. Error bars indicate standard error of the mean. All comparisons p < 0.001. MCS Mental Component Summary, PCS Physical Component Summary
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