562 Racial/ethnic differences in quality-of-life among adults with atopic dermatitis

Abstract

The Dermatology Life Quality Index (DLQI) is commonly used to measure health-related quality-of-life (QoL) in adults with skin diseases. Among patients with psoriasis, racial/ethnic minority patients were found to report higher DLQI scores, indicating greater QoL impact, than Non-Hispanic (NH) White patients. We aimed to determine whether DLQI scores differ by race/ethnicity among adults with atopic dermatitis (AD). We performed a cross-sectional study using data from the Atopic Dermatitis in America online survey. The study included adults who met age-modified United Kingdom Working Party Criteria for AD. The primary outcome was continuous DLQI score. Racial/ethnic categories were NH White [reference], NH Black, Hispanic, and NH other. Multivariable linear regression was performed to evaluate the association between race/ethnicity and logarithmically transformed DLQI scores. Effect modification by level of depression or anxiety symptoms based on the Hospital Anxiety and Depression Scale (HADS) score (≤8 [low] vs. >8 [high]) was identified. Sample weights were applied for all analyses. The study sample included 672 adults. Median (interquartile range [IQR]) age was 43 (30-58) years; 61% were women. Racial/ethnic distribution was 56% NH White, 15% NH Black, 17% Hispanic, and 12% NH other. Median (IQR) Patient-Oriented SCORing Atopic Dermatitis index was 24 (13-35) indicating mild AD severity. Median (IQR) DLQI scores by race/ethnicity were: NH White, 1.2 (0.3-4.4); NH Black, 1.7 (0.2-9.1); Hispanic, 1.6 (0.5-6.2); and NH other, 1.0 (0.3-2.9). In adjusted analyses, among those with HADS score>8, NH Black adults reported higher DLQI scores than NH White adults (β coefficient 0.56; 95% confidence interval, 0.29-0.83). Among U.S. adults with AD and greater symptoms of anxiety or depression, DLQI scores were 75% higher among NH Black vs. NH White adults. Clinicians should recognize racial/ethnic differences in the QoL impact of AD, especially among those with anxiety/depression.