Addressing the QOL Impact and Disease Burden on the Families of Adolescents With Atopic Dermatitis

Atopic dermatitis (AD) has negative impact on quality of life (QOL), and the burden of this disease in adolescents and their parents should be taken into account as part of the management of AD, according to a study in Advances in Dermatology and Venerology.

French researchers studied the burden of AD on children between the ages of 12 and 17 and their parents, because they noted that although AD in childhood has been studied previously, there are few studies on the impact of AD in young adults and adults.

Previous research has shown that family members with children who have AD may be burdened with time-consuming treatment regimens, dietary and household changes, and financial impacts. However, adolescents have not been the subject of much research.

“Adolescents face a series of challenges in developing their autonomy, identity and self-image,” they wrote. “Body image plays a more important role at this age than it does in childhood and adulthood; thus, the impact of AD on QoL in adolescents is particularly high.”

The study included 399 parents who had a child between the ages of 12 and 17 with diagnosed AD. Both parents and adolescents were asked to complete questionnaires:

• Clinical severity: the Patient-Oriented Eczema Measure (POEM)
• Quality of life measures: EQ-5D
• Dermatology Life Quality Index (DLQI)
• Children’s Dermatology Life Quality Index (CDLQI)
• Burden of disease in the family: Atopic dermatitis Burden Scale-Family (ABS-F)

More than half (57.1%) of the adolescents were boys, and 49.1% of adolescents had a disease duration of 5 years or more. According to POEM, disease severity was mild in 57.6% of patients, moderate in 32.8% of patients, and severe in 9.5% of patients.

The mean CDLQI score was 8.7, indicating the disease had a moderate impact on QOL, and the mean DLQI score was 12.8, indicating a very large effect on QOL. The lower the patient’s and parent’s QOL, the higher the patient’s disease severity, according to the questionnaire results.

The family burden according to sociodemographic and clinical variables was higher for parents with boys, children 15 years and older, and patients with a disease duration shorter than 5 years.

“It is possible that, over time, patients learn to deal with the disease and to use coping strategies,” the authors surmised.

They added that educational interventions may help to decrease the burden of AD in parents. In the current study, only 14.5% of parents had attended therapeutic patient educational sessions for AD. However, the study was not able to determine the effectiveness of these sessions.

“Effective treatment for AD is essential for adolescents’ QoL improvement and reduced burden of the disease on parents,” the authors concluded. “However, in the long-term management of the disease, educational interventions appear to be more effective than conventional treatment, and should be implemented both for patients and their parents.”

Reference

Ezzedine K, Shourick J, Merhand S, Sampogna F, Taïeb C. Impact of atopic dermatitis in adolescents and their parents: a French study. Acta Derm Venereol. Published online October 6, 2020. doi:10.2340/00015555-3653