The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology (한방안이비인후피부과학회지)

The Society of Korean Medicine Ophthalmology, Otolaryngology & Dermatology (대한한방안이비인후피부과학회)
권호 표지

The Burden of Atopic Dermatitis on Children and Their Families : Quality of Life and Financial Impact in Seoul Area

서울 지역을 대상으로 모집된 유.소아기 아토피피부염 환아의 삶의 질과 경제적 비용 부담에 관한 조사

  • 유승민 (경희대학교 한의과대학 안이비인후피부과학교실) ;
  • 최인화 (경희대학교 한의과대학 안이비인후피부과학교실)
  • Received : 2010.11.06
  • Accepted : 2010.11.30
  • Published : 2010.12.25
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : Atopic dermatitis (AD) in children may profoundly affect the quality of life (QOL), and also cause financial burden, to the families of those suffering from this ailment. The aim of our study was to examine the quality of life and the financial burden of atopic dermatitis in children and their families to evaluate this relationship with the degree of AD. Methods : 37 infant and child atopic dermatitis patients were included and evaluated using the SCORing of Atopic Dermatitis (SCORAD) Index and Eczema Area and Severity Index (EASI). Patients and carers were asked to fill in the questionnaires about their quality of life and financial costs during the past year. Data about sleep disturbance and pruritus were also obtained. Pearson's correlation was used for statistical analysis. Results : 1. The mean score of Children's Dermatology Life Quality Index (CDLQI) was $10.52{\pm}4.82$, Infants' Dermatologic Quality of Life (IDQOL) was $8.21{\pm}3.95$. 2. The mean score of Family Dermatology Life Quality Index (FDLQI) was $13.30{\pm}5.72$, Dermatitis Family Impact (DFI) was $12.5{\pm}4.98$. 3. By analyzing the questionnaire, the monthly average cost was determined to be 730,800 won for each patient : the direct cost was 283,500 won, and the indirect cost was 447,300 won. 4. By analyzing the correlation between the severity of AD and QOL, subjective SCORAD were significantly and positively correlated with QOL(IDQOL, FDLQI, DFI, CDLQI). 5. By analyzing the correlation between the severity of AD and any economic impact, EASI were significantly and positively correlated with the direct cost. Conclusion : The above results show that the QOL of the patients and carers is significantly related to their disease severity. Atopic dermatitis patients pay an average of 730,800 won a month, and the economic impact on the patients is significantly related to their disease severity. The CDLQI, IDQOL, FDLQI and DFImay potentially be of value to help in the appropriate management of AD and can be used as an added measurement in clinical trials involving AD management.

Keywords

References

  1. Leung DY, Boguniewicz M, Howell MD, Nomura I, Hamid QA. New insights into atopic dermatitis. J Clin Invest. 2004;133:651-7.
  2. Hong SJ. Korean ISAAC Study Group of Korean Association of Allergy and Respiratory Diseases: Report of Korean ISAAC epidemiologic study for asthma and allergic diseases in children. Pediatr Allergy Respir Dis(Korea) 2007;17Suppl1: S55-66.
  3. S. Howlett. Emotional dysfunction, child. family relationships and childhood atopic dermatitis. British Journal of Dermatology. 1991;140:381-4.
  4. Lewis-Jones MS, Finlay AY. The Children's Dermatology Life Quality Index (CDLQI): initial validation and practical use. British Journal of Dermatology. 1995;132(6):942-9.
  5. 박창근, 박천욱, 이철헌. 유소아기 아토피피부염이 환아의 삶의 질과 가족에 미치는 영향. 대한피부과학회지. 2007;45(5):429-38.
  6. Lapidus CS, Schwarz DF, Honig PJ. Atopic dermatitis inchildren: who cares? Who pays? J Am Acad Dermatol. 1993;28(5 Pt 1):699-703. https://doi.org/10.1016/0190-9622(93)70096-C
  7. Ellis CN, Drake LA, Prendergast MM. Cost of atopic dermatitis and eczema in the United States. J Am Acad Dermatol. 2002;46:361-70. https://doi.org/10.1067/mjd.2002.120528
  8. Ehlken B, Mohrenschlager M, Kugland B, Berger K, Quednau K, Ring J. Cost-of-illness study in patients suffering from atopic eczema in Germany. Hautarzt. 2005;56(12):1144-51. https://doi.org/10.1007/s00105-005-0953-2
  9. Verboom P, Hakkaart-Van L, Sturkenboom M, et al. The cost of atopic dermatitis in the Netherlands : an international comparison. Br J Dermatol. 2002;147:716-24. https://doi.org/10.1046/j.1365-2133.2002.04964.x
  10. Fivenson D, Arnold RJ, Kaniecki DJ, Cohen JL, Frech F, Finlay AY. The effect of atopic dermatitis on total burden of illness and quality of life on adults and children in a large managed care organization. J Manag Care Pharm. 2002;8(5):333-42.
  11. Nicole Jenner, Jan Campbell, Robin Marks. Morbidity and cost of atopic eczema in Australasian Journal of Dermatology. 2004;45:16-22. https://doi.org/10.1111/j.1440-0960.2004.00046.x
  12. Martin Barbeau M, Helene Lalonde, Bpharm. Burden of Atopic dermatitis in Canada. Int J Dermatol. 2006;45(1):31-6. https://doi.org/10.1111/j.1365-4632.2004.02345.x
  13. 김은정, 김형옥, 박영민. 아토피피부염 환자의 삶의 질과 경제적 부담에 관한 연구. 대한피부과학회지. 2008;46(2):160-70.
  14. 윤영희, 최인화. 서울 지역을 대상으로 모집된 성인 아토피피부염 환자의 삶의 질과 경제적 비용 부담에 관한 조사. 한방안이비인후피부과학회지. 2010;23(1):199-214.
  15. Christie L. Carroll, Rajesh Balkrishnan, Steven R. Feldman, Alan B. Fleischer Jr., Janeen C. Manuel. The Burden of Atopic Dermatitis: Impact on the Patient, Family, and Society. Pediatric Dermatology. 2005; 2(3):192-9.
  16. Mancini AJ, Kaulback K, Chamlin SL. The socioeconomic impact of atopic dermatitis in the United States: a systematic review. Pediatr Dermatol. 2008;25(1):1-6. https://doi.org/10.1111/j.1525-1470.2007.00572.x
  17. Ricci G, Bendandi B, Pagliara L, Patrizi A, Masi M. Atopic Dermatitis in Italian Children: Evaluation of Its Economic Impact. Journal of Pediatric Health Care. 2006;20(5):311-5. https://doi.org/10.1016/j.pedhc.2006.04.009
  18. Su JC, Kenp AS, Varigos GA, Nolan TM. Atopic eczema:its impact on the family and financial cost. Arch Dis Child. 1997;76:159-62. https://doi.org/10.1136/adc.76.2.159
  19. Emerson RM, Williams HC, Allen BR. What is the cost of atopic dermatitis in preschool children? Br J Dermatol. 2001; 144:514-22. https://doi.org/10.1046/j.1365-2133.2001.04077.x
  20. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol. 1980;92:44-7.
  21. Hanifin JM, Thurston M, Cherill R, Tofte SJ, Graeber M, the EASI Evaluator Group. The eczema area and severity index(EASI). assessment of reliability in atopic deermatitis. Exp Dermatol. 2001;10:11-8. https://doi.org/10.1034/j.1600-0625.2001.100102.x
  22. Lewis-Jones MS, Finlay AY, Dykes PJ. The Infinats' Dermatitis Quality of Life Index. Br J Dermatol. 2001;144:104-10. https://doi.org/10.1046/j.1365-2133.2001.03960.x
  23. Basra MK, Sue-Ho R, Finlay AY. The Family Dermatology Life Quality Index: measuring the secondary impact of skin disease. British Journal of Dermatology. 2007;156(3):528-38. https://doi.org/10.1111/j.1365-2133.2006.07617.x
  24. Lawson V, Lewis-Jones MS, Finlay AY, Reid P, Owens RG. The family impact of childhood atopic dermatitis: the Dermatitis Family Impact Questionnaire. Br J Dermatol. 1998;138:107-13. https://doi.org/10.1046/j.1365-2133.1998.02034.x
  25. Ben-Gashir MA, Seed PT, Hay RJ. Quality of life and disease severity are corrleated in children with atopic dermatitis. Br JDermatol. 2004;150:284-90. https://doi.org/10.1111/j.1365-2133.2004.05776.x
  26. 이희정, 박창욱, 이주희, 이광훈. 성인 아토피피부염 환자에게 삶의 질 평가의 임상적 유용성. 대한피부과학회지. 2007;45(2):159-64.
  27. Ricci G, Bendandi B, Bellini F, Patrizi A, Masi M. Atopic dermatitis: quality of life of young Italian children and their families and correlation with severity score. Pediatr Allergy Immunol. 2007;18(3):245-9. https://doi.org/10.1111/j.1399-3038.2006.00502.x
  28. 신나라, 김성현, 조소연, 황규광, 함정희. 소아기 아토피피부염이 가족에 미치는 영향에 관한 연구. 대한피부과학회지. 2000;38(4): 94-499.
  29. Basra MK, Sue-Ho R, Finlay AY. The Family Dermatology Life Quality Index: measuring the secondary impact of skin disease. British Journal of Dermatology. 2007;156(3):528-38. https://doi.org/10.1111/j.1365-2133.2006.07617.x
  30. Balkrishnan R, Housman TS, Carroll C, Feleman SR, Fleischer AB. Disease severity and associated family impact in childhood atopic dermatitis. Arch Dis Child. 2003;88:423-7. https://doi.org/10.1136/adc.88.5.423
  31. 유일영, 김동희. 아토피 피부염 환아 어머니의 양육 스트레스와 간호 요구. 아동간호학회지. 2004;10(4):423-30.
  32. 김성현, 한덕현, 박혜진, 변지연, 최유원, 최혜영, 명기범. 소아청소년 아토피피부염 환자의 애착반응 및 부모의 삶의 질과의 관계. 대한피부과학회지. 2008;46(11):1457-62.
  33. 진현우, 장호선, 장봉석, 조주현. 김문범, 오창근. 권경술, 권유욱. 아토피피부염 환자의 대체의학 이용 실태에 관한 연구. 대한피부과학회지. 2005;43(7):903-11.