title: Loss of Work Productivity and Quality of Life in Patients With Autoimmune Bullous Dermatoses.
abstract: BACKGROUND
  Little is known about quality of life and work productivity in autoimmune bullous dermatoses (AIBDs).
  
  
  OBJECTIVE
  To determine the impact of AIBDs on quality of life and work productivity.
  
  
  METHODS
  An observational cross-sectional study took place between February and May 2013 at an AIBD tertiary referral centre. Ninety-four patients were included. All participants completed the Dermatology Life Quality Index and the Work Productivity and Activity Impairment-Specific Health Problem questionnaires.
  
  
  RESULTS
  Responders to treatment had less impairment (P<.001) than nonresponders. Patients with severe AIBD had significantly more impairment that those with mild (P<.001) and moderate (P=.002) AIBD. Greater impairment was associated with higher percentage of work missed. Those with a higher Dermatology Life Quality Index score had greater work impairment and overall activity impairment (P=.041, P=.024). Nonresponders had increased impairment while working (P<.001), overall work impairment (P<.001), and activity impairment (P<.001). Severely affected patients had worse impairment in all Work Productivity and Activity Impairment Questionnaire domains.
  
  
  CONCLUSIONS
  AIBD has the potential to be a large burden on ability to work and quality of life. Larger studies are needed to clarify how these domains change over time and whether or not they improve with treatment.
authors.affiliation: Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada karaheelan@yahoo.com.
authors.forename: K
authors.initials: K
authors.lastname: Heelan
authors.affiliation: Institute for Life Course and Aging, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: S L
authors.initials: SL
authors.lastname: Hitzig
authors.affiliation: Division of Clinical Pharmacology and Toxicology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Department of Pharmacology, University of Toronto, Toronto, ON, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Knowles
authors.affiliation: Division of Dermatology, University Health Network, Toronto, ON, Canada.
authors.forename: A M
authors.initials: AM
authors.lastname: Drucker
authors.affiliation: Division of Clinical Pharmacology and Toxicology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Department of Pharmacology, University of Toronto, Toronto, ON, Canada Health Outcomes and PharmacoEconomics (HOPE) Research Centre, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Mittmann
authors.affiliation: Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Walsh
authors.affiliation: Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Division of Clinical Pharmacology and Toxicology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: N H
authors.initials: NH
authors.lastname: Shear
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000150:complications* / Q000523:psychology / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069597:Presenteeism; D011788:Quality of Life; D012720:Severity of Illness Index; D012872:Skin Diseases, Vesiculobullous / Q000150:complications* / Q000523:psychology* / Q000628:therapy; D055815:Young Adult
keywords: Dermatology Life Quality Index; Work Productivity and Activity Impairment; autoimmune bullous disorders; quality of life