title: The Impact of Chronic Urticaria from the Patient's Perspective: A Survey in Five European Countries.
abstract: BACKGROUND
  Chronic spontaneous urticaria (CSU) is associated with considerable burden, but data from European patients are limited.
  
  
  METHODS
  This study is a retrospective, cross-sectional analysis of National Health and Wellness Survey data from the five largest EU countries (5EU: France, Germany, Italy, Spain, and the UK) collected between 2010 and 2013. Burden of disease for patients with CSU was estimated by comparing individuals currently treated for chronic urticaria (proxy CSU cases) with controls selected from respondents without chronic urticaria. Matching and regression models were used to quantify the impact of chronic urticaria on health-related quality of life, self-reported psychological complaints, work and activity impairment, and healthcare use.
  
  
  RESULTS
  The sample included 175,923 respondents. Prevalence of diagnosed chronic urticaria was 0.5 and 0.2% were treating the condition with a prescription. Cases (N = 369) had substantially lower (worse) regression-adjusted mean Mental Component Summary (40.2 vs. 45.4), Physical Component Summary (44.6 vs. 49.9), and SF-6D health utility scores (0.63 vs. 0.71; all p < 0.001) relative to controls (N = 1476), differences that exceed accepted minimally important differences for these measures. Depression, anxiety, and sleep difficulties were approximately twice as prevalent among those currently receiving treatment for chronic urticaria (all p < 0.001). Cases also had elevated presenteeism (31 vs. 17%), overall work impairment (37 vs. 20%), and impairment in non-work activities (42 vs. 26%; all p < 0.01) relative to controls. Physician visits (9.1 vs. 4.9), emergency room visits (0.8 vs. 0.3), and hospitalizations (0.3 vs. 0.2) were more frequent than in controls (all p < 0.01).
  
  
  CONCLUSIONS
  This research adds to the existing evidence showing significant burden of CSU.
authors.affiliation: Novartis Pharma AG, IHC, Basel, Switzerland.
authors.forename: Maria-Magdalena
authors.initials: MM
authors.lastname: Balp
authors.affiliation: Kantar Health, Health Outcomes Practice, 700 Dresher Road, Horsham, PA, 19044, USA. jeffrey.vietri@kantarhealth.com.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Vietri
authors.affiliation: Novartis Pharmaceutical Corporation, Global Medical Affairs, East Hanover, NJ, USA.
authors.forename: Haijun
authors.initials: H
authors.lastname: Tian
authors.affiliation: Kantar Health, Health Outcomes Practice, Epsom, Surrey, UK.
authors.forename: Gina
authors.initials: G
authors.lastname: Isherwood
mesh_terms: D000041:Absenteeism; D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000453:epidemiology; D002908:Chronic Disease; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005060:Europe; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D012890:Sleep; D012959:Socioeconomic Factors; D014581:Urticaria / Q000453:epidemiology / Q000523:psychology*