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Kini SP, DeLong LK, Veledar E, McKenzie-Brown AM, Schaufele M, Chen SC. The Impact of Pruritus on Quality of Life: The Skin Equivalent of Pain. Arch Dermatol. 2011;147(10):1153–1156. doi:10.1001/archdermatol.2011.178
Author Affiliations: Departments of Dermatology (Drs Kini, DeLong, Veledar, and Chen), Anesthesiology and Pain Medicine (Dr McKenzie-Brown), and Rehabilitation Medicine (Dr Schaufele), Emory University School of Medicine, and Department of Health Services Research & Development, Division of Dermatology, Veterans Affairs Medical Center (Dr Chen), Atlanta, Georgia.
Objective To compare the impact of chronic pruritus and chronic pain on quality of life (QoL) using directly elicited health utility scores.
Design Cross-sectional study.
Setting Convenience sample of patients attending the Emory Dermatology Clinic, Emory Spine Center, and Emory Center for Pain Management, Atlanta, Georgia.
Participants Adult men and women (aged ≥18 years) experiencing chronic pain or pruritus for 6 weeks or more.
Main Outcome Measures The mean utility score of patients with chronic pruritus was compared with that of patients 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 metric representing the impact on QoL).
Results The study included 73 patients with chronic pruritus and 138 patients with chronic pain. The mean (SD) utility among patients with pruritus was 0.87 (0.27) compared with 0.77 (0.31) for patients with pain (P < .01). After symptom severity, duration, and demographic factors were controlled for, only symptom severity (0.03 [P < .05]) and single marital status ( −0.12 [P = .02]), but not symptom type (P = .43), remained significant predictors of the mean symptom utility score.
Conclusions Chronic pruritus has a substantial impact on QoL, one that may be comparable to that of pain. The severity of symptoms and the use of support networks are the main factors that determine the degree to which patients are affected by their symptoms. Addressing support networks in addition to developing new therapies may improve the QoL of itchy patients.
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