title: Onychomycosis: health-related quality of life considerations.
abstract: The symptoms of onychomycosis and their impact on personal appearance are important determinants of patients' perceptions of their own health. The effect of onychomycosis is greater on psychosocial than physical functioning and is directly related to the extent of nail involvement. This review identified a number of disease-targeted questionnaires that have been developed to assess the impact of onychomycosis and its treatment on health-related quality of life (HR-QOL). The instruments differ considerably in the extent to which they have been psychometrically tested. Most have been shown to provide both valid and reliable measurement of HR-QOL in patients with onychomycosis of the toes. However, not all have been tested in patients with fingernail disease. The generic and disease-targeted scales of most of the available questionnaires exhibit poor variability, which may limit their responsiveness to clinically important change. Only one instrument, the Onychomycosis Disease-Specific Questionnaire, has been incorporated into a clinical trial. Thus, information relating to the impact of onychomycosis treatment on HR-QOL is limited. Future efforts should focus on the systematic evaluation of existing questionnaires in all populations for which they were developed. In addition, it is important that disease-targeted measures be included in future clinical trials so that a better understanding of the impact of onychomycosis treatment on patient HR-QOL may be gained.
authors.affiliation: Department of Pharmaceutical Sciences and the Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, Arizona 85721, USA. shaw@pharmacy.arizona.edu
authors.forename: James W
authors.initials: JW
authors.lastname: Shaw
authors.forename: Vijay N
authors.initials: VN
authors.lastname: Joish
authors.forename: Stephen Joel
authors.initials: SJ
authors.lastname: Coons
mesh_terms: D005069:Evaluation Studies as Topic; D006801:Humans; D014009:Onychomycosis / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires / Q000592:standards