Assessing the Burden of Hidradenitis Suppurativa and the Influence of Social Determinants of Health on Patient-Reported Quality of Life
Author(s)
Ebuka I. Onyenobi, MS1, Godwin Ejike Okoye, MS, RPh2, Nkem J. Ekeruche, PharmD3.
1Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA, 2Health Outcomes Division, College of Pharmacy, University of Texas at Austin, Austin, TX, USA, 3Clinical Services, Precision AQ, New York, NY, USA.
1Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA, 2Health Outcomes Division, College of Pharmacy, University of Texas at Austin, Austin, TX, USA, 3Clinical Services, Precision AQ, New York, NY, USA.
OBJECTIVES: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition. The role of social determinants of health (SDOH) in shaping disease experience and quality of life (QoL) remains understudied. This study aimed to evaluate the impact of HS on patient reported QoL and to assess the influence of SDOH on QoL outcomes.
METHODS: Using data from the All of Us Research Program, patients with HS were matched to controls in a 1:2 ratio using propensity score matching based on age, sex, race, BMI, and smoking status. QoL was assessed using the PROMIS Global Health v1.2 short form, with physical and mental health measures converted to T-scores where higher scores indicated better QoL. Multivariable linear regression models were used to evaluate the association between HS and QoL in the full matched sample, as well as the association between SDOH factors and QoL among patients with HS only.
RESULTS: A total of 1,748 patients with HS were matched to 3,496 controls. HS was significantly associated with lower physical (β = -2.76) and mental (β = -2.11) QoL compared to matched controls (p < 0.001). Among patients with HS, several SDOH including, lower educational attainment (β = -6.81), unemployment (β = -9.09), low income (β = -9.08), Medicaid insurance coverage (β = -5.97), and housing insecurity (β = -3.65) were independently associated with lower physical QoL (p < 0.001). Mental health QoL demonstrated similar trends. Racial disparities were also observed with Hispanic (β = -2.59) and Black (β = -1.36) patients reporting significantly lower physical QoL than White patients (p < 0.001).
CONCLUSIONS: HS is associated with significant impairments in QoL that are further influenced by socioeconomic and racial disparities. Addressing these factors may be essential to improving outcomes and promoting health equity in the management of HS.
METHODS: Using data from the All of Us Research Program, patients with HS were matched to controls in a 1:2 ratio using propensity score matching based on age, sex, race, BMI, and smoking status. QoL was assessed using the PROMIS Global Health v1.2 short form, with physical and mental health measures converted to T-scores where higher scores indicated better QoL. Multivariable linear regression models were used to evaluate the association between HS and QoL in the full matched sample, as well as the association between SDOH factors and QoL among patients with HS only.
RESULTS: A total of 1,748 patients with HS were matched to 3,496 controls. HS was significantly associated with lower physical (β = -2.76) and mental (β = -2.11) QoL compared to matched controls (p < 0.001). Among patients with HS, several SDOH including, lower educational attainment (β = -6.81), unemployment (β = -9.09), low income (β = -9.08), Medicaid insurance coverage (β = -5.97), and housing insecurity (β = -3.65) were independently associated with lower physical QoL (p < 0.001). Mental health QoL demonstrated similar trends. Racial disparities were also observed with Hispanic (β = -2.59) and Black (β = -1.36) patients reporting significantly lower physical QoL than White patients (p < 0.001).
CONCLUSIONS: HS is associated with significant impairments in QoL that are further influenced by socioeconomic and racial disparities. Addressing these factors may be essential to improving outcomes and promoting health equity in the management of HS.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR22
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Rare & Orphan Diseases, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)