Impact of chronic urticaria on quality of life and work in Japan: Results of a real-world study

Abstract

Little attention has been given to the burden of chronic urticaria (CU) in Japan compared with other skin diseases, such as atopic dermatitis (AD) and psoriasis. The primary objective of the RELEASE study was to evaluate the real-life quality-of-life impairment in CU patients in Japan. Data were collected from 1443 urticaria, 1668 AD and 435 psoriatic patients; 552 urticaria patients who presented urticaria symptoms for over 6 weeks were defined as CU. The mean Dermatology Life Quality Index (DLQI) total score was 4.8, 6.1 and 4.8 in CU, AD and psoriatic patients, respectively. Disease control of urticaria evaluated by the Urticaria Control Test (UCT) and DLQI exhibited a strong correlation with a Spearman's rank correlation coefficient of -0.7158. CU and AD patients had relatively higher scores in all Work Productivity and Activity Impairment - General Health subscales except for absenteeism. At the time of the survey, approximately 64% of CU patients reported UCT scores of <12 and demonstrated higher work productivity loss and activity impairment versus patients with UCT scores of ≥12. Patients with lower UCT scores also displayed a higher percentage of dissatisfaction with their health state and the treatment they received. Approximately 85% of patients with CU had visited dermatology clinics, and less than 20% had visited hospital, indicating existence of a highly burdened population outside specialized centers. These results highlight the unmet medical needs of CU patients, suggesting the need to increase awareness of CU burden among both physicians and patients and to pursue improved real-life patient care.

Keywords: Japanese; chronic urticaria; quality of life; questionnaires; urticaria.

Figure 1

DLQI score. (a) Total score. (b) DLQI scores according to UCT score range in CU patients. (c) Correlation between UCT and DLQI. The aim of this questionnaire was to measure how much the patient's skin problem had affected their life over the last week. CU, chronic urticaria; DLQI, Dermatology Life Quality Index; SD, standard deviation; UCT Urticaria Control Test.

Figure 2

Visit to HCP by CU patients. (a) HCP (ever visited). (b) HCP (currently visiting). Patients were asked: Q. “Which physicians did you already see for your skin problems? Multiple choices can be made”; Q. “Which physician is currently treating you for your skin problems? Multiple choices can be made”. CU, chronic urticaria; HCP, health‐care providers.

Figure 3

Satisfaction with health state. (a) Satisfaction with health state/current. (b) Satisfaction with health state/under the severest condition within the past 1 year. Patients were asked: Q. “Overall, are you satisfied with current health state?”; Q. “How much were you satisfied with your health state when you experienced the severest symptoms?”. CU, chronic urticaria.

Figure 4

Satisfaction with treatment. (a) Satisfaction with treatment. (b) Reason for not being satisfied with treatment. Data on the reason for not being satisfied with treatment were obtained from those who selected “not satisfied with treatment”. Patients were asked: Q. “Are you satisfied with the current medical care you receive?”; Q. “Why are you unsatisfied with the medical care?”. CU, chronic urticaria.

Figure 5

Satisfaction assessment/current by UCT score range in CU patients. (a) Satisfaction with health state. (b) Satisfaction with treatment. CU, chronic urticaria; UCT, Urticaria Control Test.