Pruritus: the skin equivalent of pain as measured by health utilities Öffentlichkeit

Abstract

Abstract
Objective : To compare the quality of life impact of chronic pruritus to that of chronic pain using
directly elicited health utilities
Design: Cross-sectional study
Setting: Convenience sample of patients attending the Emory Dermatology Clinic, Emory Spine
Center, and Emory Center for Pain Management.
Participants: Adult men and women (≥18 years) experiencing chronic pain or pruritus for a
minimum of 6 weeks
Main Outcome Measure: The mean utility score of subjects with chronic pruritus was
compared to that of subjects with chronic pain. A regression analysis was performed to
determine the impact of the primary predictor variable, symptom type, on the primary outcome
variable, mean utility score (a measurement for quality of life impact)
Results: 73 subjects with chronic pruritus and 138 subjects with chronic pain were recruited.
Mean (SD) utility among patients with pruritus was 0.874 (0.27) compared to 0.767 (0.31) for
subjects with pain (p<0.001). After controlling for symptom severity, duration, and demographic
factors, only symptom severity (-0.03, p=0.048) and single marital status (-0.12, p= 0.02) and not
symptom type (0.05, p= 0.43) remained a significant predictor of mean utility score.
Conclusions : Chronic pruritus has substantial quality of life impact which may be comparable to
that of pain. Symptom severity and support networks are important factors in determining the
extent of quality of life impact. Addressing support networks in addition to developing new
therapies may improve the quality of life of itchy patients.

Table of Contents

I. Introduction……………………………………………………………………………………………….1

II. Background………………………………………………………………………………………………..2

IIa. Pruritus………………………………………………………………………………………………..2

IIb. Pruritus and pain………………………………………………………………………………….3

IIc. Health-related quality of life………………………………………………………………..4

IId. Health utilities in dermatology…………………………………………………………….4

III. Methods…………………………………………………………………………………………………….6

IIIa. Survey variables……………………………………………………………………………………8

IIIb. Statistical Analyses……………………………………………………………………………….8

IIIc. Power Analysis……………………………………………………………………………………..8

IV. Results………………………………………………………………………………………………………..10

IVa. Demographics and Characteristics of Pain and Pruritus Cohorts………….10

IVb. Results of Multivariate Regression Model……………………………………………11

V. Discussion……………………………………………………………………………………………………12

Va. Limitations…………………………………………………………………………………………….13

Vb. Conclusions…………………………………………………………………………………………..15

VI. References…………………………………………………………………………………………………16

VII. Tables…………………………………………………………………………………………………………18

VIII. Appendix…………………………………………………………………………………………………..20

About this Master's Thesis

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School	Laney Graduate School
Department	Clinical Research Curriculum Program
Degree	MS
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Stichwort	Pruritus Pain
Committee Chair / Thesis Advisor	Chen, Suephy, Emory University
Committee Members	Boring, John R, Emory University McGowan Jr., John E, Emory University Ziegler, Thomas R, Emory University

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