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. 2023 Apr 12:16:383-396.
doi: 10.2147/JAA.S404350. eCollection 2023.

Implications of Atopic Dermatitis on the Quality of Life of 6-11 Years Old Children and Caregivers (PEDI-BURDEN)

Iria Neri  1 , Elena Galli  2 , Ilaria Baiardini  3   4 , Mario Picozza  5   6 , Ana B Rossi  7 , Paolo Matruglio  8 , Devis Moretti  8 , Filippo Cipriani  8
Affiliations

Implications of Atopic Dermatitis on the Quality of Life of 6-11 Years Old Children and Caregivers (PEDI-BURDEN)

Iria Neri et al. J Asthma Allergy. .

Abstract

Purpose: Atopic dermatitis (AD) is a chronic, relapsing and remitting inflammatory skin disease characterized by intense itch. The disease burden includes physical limitations, psychosocial discomfort, and a reduced quality of life (HRQoL). This study presents the results of a parent-reported survey on the psychosocial impact of AD on Italian pre-adolescent children (6-11 years old), with a specific focus on bullying, self-isolation, absenteeism, and presenteeism.

Methods: An online questionnaire was sent to 3067 random recipients and 160 matched the inclusion criteria for age, self-reported AD diagnosis, localizations (according to ISAAC), and disease severity (POEM ≥8). 100 children, with comparable ages, not matching the inclusion criteria for AD, were recruited as a control group.

Results: Children with AD and their caregivers had a significantly lower quality of sleep (QoS) compared to the control group. The presence of AD was directly responsible for many restless nights, both in children and caregivers (58.9 and 55.4 respectively). Children with AD and their parents also experienced significantly more daytime drowsiness (43.6 and 54.6 days, respectively). Children with AD were more frequently victims of bullying at school (20.0% vs 9.0%; p≤0.05) or in other social environments (16.9% vs 3.0%; p≤0.05). AD caused 17.7 days of absenteeism and 20.1 days of presenteeism per student over the previous 12 months, accounting for 37.8 days of study impairment overall. Severe/very severe AD had a significantly greater impact on presenteeism than moderate AD (25.1 vs 17.5 days; p≤0.05). Presenteeism, which was more pronounced among bullied students, was positively correlated with absenteeism only in the AD cohort.

Conclusion: AD has a detrimental impact on the HRQoL of pediatric patients, causing stigmatization and social isolation. Functional distress was also reported by caregivers. Our study might inform the public and policymakers about the disease burden of AD at a young age.

Keywords: absenteeism; atopic dermatitis; daily drowsiness; presenteeism; sleep impairment.

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Conflict of interest statement

I. Neri acts as advisor, speaker, investigator and/or consultant for Sanofi, Janssen, Roche-Posay, Giuliani, Leo Pharma. E. Galli reports scientific consultations and/or lectures for Lofarma, Hal_Allergy and Sanofi. I. Baiardini IB reports scientific consultations and/or lectures from Boehringer Ingelheim, Chiesi Farmaceutici, GlaxoSmithKline, Menarini, Novartis, Sanofi, Biofutura, Mundifarma, AstraZeneca. M. Picozza declares no conflicts of interest in this work. AB. Rossi, P. Matruglio, D. Moretti and F. Cipriani are Sanofi employees, and may hold stock and/or stock options in the company.

Figures

Figure 1
Figure 1
Limitations and implications on daily activities.
Figure 2
Figure 2
Emotional burden.
Figure 3
Figure 3
Sleep impairment and daily drowsiness.
Figure 4
Figure 4
Absenteeism and presenteeism.
See this image and copyright information in PMC

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