title: The burden of common skin diseases assessed with the EQ5D™: a European multicentre study in 13 countries.
abstract: BACKGROUND
  Generic instruments measuring health-related quality of life (HRQoL), like EQ5D™, enable comparison of skin diseases with healthy populations and nondermatological medical conditions, as well as calculation of utility data.
  
  
  OBJECTIVE
  To measure HRQoL in patients with common skin diseases and healthy controls across Europe using the EQ5D.
  
  
  METHODS
  This multicentre observational cross-sectional study was conducted in 13 European countries. Each dermatology clinic recruited at least 250 consecutive adult outpatients to complete questionnaires, including the EQ5D.
  
  
  RESULTS
  There were 5369 participants (4010 patients and 1359 controls). Mean ± SD self-rated health state reported by patients was 69·9 ± 19·7; for controls it was 82·2 ± 15·5. When adjusted for confounding factors, including comorbidity, mean patient EQ visual analogue scores were 10·5 points lower than for controls (standardized β = -0·23). Odds ratio with 95% confidence interval for impairment in all five dimensions of EQ5D adjusted for confounders was doubled for patients compared with controls. Patients with hidradenitis suppurativa (HS), blistering conditions, leg ulcers, psoriasis and eczemas had the highest risk for reduction in HRQoL in most dimensions (2-10-fold). Data on differences of impairment by dimensions offer new insights.
  
  
  CONCLUSIONS
  This study confirms the large impact skin conditions have on patients' well-being, differentiating between aspects of HRQoL. Patients with HS, blistering diseases, leg ulcers, infections and most chronic skin diseases reported reduced HRQoL compared with patients with chronic obstructive lung disease, diabetes mellitus, cardiovascular disease and cancers. These findings are important in the prioritization of resource allocation between medical fields and within dermatological subspecialities.
authors.affiliation: Department of Dermatology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: F
authors.identifier: http://orcid.org/0000-0002-1939-2142
authors.initials: F
authors.lastname: Balieva
authors.affiliation: Institute of Medical Psychology, Justus Liebig University, Giessen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Kupfer
authors.affiliation: Innlandet Hospital Trust, Brumundal, Norway.|Hedmark University College, Elverum, Norway.
authors.forename: L
authors.initials: L
authors.lastname: Lien
authors.affiliation: Department of Dermatology, Justus Liebig University, Giessen, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Gieler
authors.affiliation: Department of Dermatology, Cardiff University School of Medicine, Cardiff, U.K.
authors.forename: A Y
authors.initials: AY
authors.lastname: Finlay
authors.affiliation: Department of Psychology, University of Zaragoza, Zaragoza, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Tomás-Aragonés
authors.affiliation: Department of Dermatology, ULB, Hospital Erasme, Brussels, Belgium.
authors.forename: F
authors.initials: F
authors.lastname: Poot
authors.affiliation: Department of Dermatology, University Hospital of Brest, Brest, France.|Laboratory of Neurosciences of Brest, University of Western Brittany, Brest, France.
authors.forename: L
authors.initials: L
authors.lastname: Misery
authors.affiliation: Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Sampogna
authors.affiliation: Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: van Middendorp
authors.affiliation: Department of Dermatology, Oslo University Hospital Rikshospitalet, University of Oslo, Oslo, Norway.
authors.forename: J A
authors.initials: JA
authors.lastname: Halvorsen
authors.affiliation: Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: J C
authors.initials: JC
authors.lastname: Szepietowski
authors.affiliation: Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia.
authors.forename: A
authors.initials: A
authors.lastname: Lvov
authors.affiliation: Department of Dermatology, Alcaniz Hospital, Alcaniz, Spain.
authors.forename: S E
authors.initials: SE
authors.lastname: Marrón
authors.affiliation: Department of Pharmacy, Pharmacology and Postgraduate Medicine, School of Life and Medical Sciences, Hatfield, U.K.
authors.forename: M S
authors.initials: MS
authors.lastname: Salek
authors.affiliation: Department of Dermatology and Venereology, Skåne University Hospital, Lund University, S-20502, Malmö, Sweden.
authors.forename: F J
authors.initials: FJ
authors.lastname: Dalgard
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000453:epidemiology; D011788:Quality of Life; D012648:Self Care / Q000706:statistics & numerical data; D012871:Skin Diseases / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult