OBJECTIVES

The Dermatology Life Quality Index(DLQI) is a validated measure of health-related quality of life(HRQoL) but may not capture the entire picture of patient QoL in psoriasis. We evaluated whether in patients with mild DLQI self-reported severity reflected healthcare resource utilization(HRU) and other patient reported outcomes(PROs) in the USA and Europe(France,Germany,Italy,Spain,UK).

METHODS

Data from the 2019 US and 2020 EU National Health and Wellness Survey (NHWS), a nationally-representative, cross-sectional online survey, was analyzed. Patients who self-reported physician-diagnosed psoriasis with a DLQI score<5 (mild) were stratified on their self-reported severity (mild vs moderate/severe) when untreated and their HRU and HRQoL (SF-12v2 PCS/MCS, SF-6D,EQ-5D), PROs (EQ-5D,GAD-7,PHQ-9) and work productivity (WPAI) were analyzed using regression models and results were reported as marginal means.

RESULTS

Among psoriasis patients with DLQI<5 in the USA (n=1401, mild=837, moderate/severe=564), moderate/severe patients had more visits to healthcare providers (HCP) in the past 6 months (5.90 vs 4.88, p<0.01) and lower EQ-5D index scores (0.78 vs 0.80, p=0.03) compared to self-reported mild when controlling for age and education.

Among EU patients(n=1910, mild=1225, moderate/severe= 685), models (controlling for age, education, and income) showed moderate/severe patients had lower SF-12v2 PCS (47.90 vs 49.98, p=0.01), SF-6D Index (0.68 vs 0.70, p=0.01), and EQ-5D Index scores (0.78 vs 0.80, p=0.02). Moderate/severe patients had higher HRU, including number of HCP visits (7.01 vs 5.88, p<0.01), ED visits (0.33 vs 0.22, p=0.01), and hospitalizations (0.14 vs 0.08, p<0.01) in the past 6 months.

Mental health measures including depression (PHQ-9) and anxiety (GAD-7) and work productivity (WPAI) outcomes, while directionally worse, were not significant in the multivariable models in either the USA or EU. No correction was made for multiplicity.

CONCLUSIONS

Among psoriasis patients with DLQI<5, patient perception of higher severity correlates with higher HRU and lower overall QoL in the USA and EU.