title: Health related quality of life in patients with actinic keratosis--an observational study of patients treated in dermatology specialist care in Denmark.
abstract: BACKGROUND
  Actinic keratosis (AK) is a common skin condition that may progress to non-melanoma skin cancer (NMSC). The disease may influence Health Related Quality of Life (HRQoL), but studies of HRQoL in patients with AK are limited. The purpose of the study was to analyze HRQoL in patients with different severity levels of AK treated in dermatology specialist care using generic and disease-specific HRQoL instruments and to analyze their relationship.
  
  
  METHODS
  AK patients who visited dermatological clinics in Denmark were included in an observational, cross-sectional, study in a multi-center setting. Dermatologists assessed AK severity and patients completed: Actinic Keratosis Quality of Life Questionnaire (AKQoL), Dermatology Life Quality Index (DLQI), and EQ-5D-5 L including EQ-VAS. Differences between categorical subgroups were tested with Wilcoxon rank-sum test. The relationship between instruments was analyzed with the Spearman correlation test.
  
  
  RESULTS
  A total of 312 patients were included in the analyses. Patients reported impairment in the disease specific HRQoL instrument AKQoL (mean AKQoL 6.7, DLQI 2, EQ-5D-5 L 0.88, and EQ-VAS 79). HRQoL was least affected in patients with mild actinic disease, whereas patients with severe actinic damage suffered from further impaired HRQoL (mean AKQoL 10.1 and DLQI 4.6). Correlations between DLQI and AKQoL were moderate, whereas the correlations between DLQI and EQ-5D-5 L and between AKQoL and EQ-5D-5 L were weak.
  
  
  CONCLUSIONS
  Patients with severe actinic damage showed more impairment in HRQoL than those with mild disease. Correlations between instruments suggest that they are complementary as they measure different aspects of HRQoL and are used for different purposes.
authors.affiliation: IHE, The Swedish Institute for Health Economics, P.O. Box 2127, SE-220 02, Lund, Sweden. grt@ihe.se.
authors.forename: Gunnel Ragnarson
authors.initials: GR
authors.lastname: Tennvall
authors.affiliation: IHE, The Swedish Institute for Health Economics, P.O. Box 2127, SE-220 02, Lund, Sweden. jn@ihe.se.
authors.forename: J M
authors.initials: JM
authors.lastname: Norlin
authors.affiliation: LEO Pharma AB, Malmö, Sweden. irena.malmberg@leo-pharma.com.
authors.forename: I
authors.initials: I
authors.lastname: Malmberg
authors.affiliation: Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. andres.erlendsson@gmail.com.
authors.forename: A M
authors.initials: AM
authors.lastname: Erlendsson
authors.affiliation: Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. mhaedersdal@dadlnet.dk.
authors.forename: M
authors.initials: M
authors.lastname: Hædersdal
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003718:Denmark; D003879:Dermatologic Agents / Q000627:therapeutic use; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D055623:Keratosis, Actinic / Q000188:drug therapy / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires / Q000592:standards*
chemical_list: D003879:Dermatologic Agents