The Effect of Hospitalization on Quality of Life in Dermatology Inpatients
Abstract
Objective: Quality of life (QOL) measures have been used as assessment parameters in the management of chronic skin diseases. Our aim is to demonstrate the effect of inpatient therapy on the health-related QOL.
Materials and methods: This study comprised 509 patients with skin diseases. Possible effects of inpatient therapy on QOL were measured as pre/post-treatment differences in Dermatology Life Quality Index (DLQI) and short form (SF)-36 health survey tests’ mean scores.
Results: The most common reasons necessitating the admission were severity of skin disease or acute deterioration of disease (46.1%). The mean DLQI value for all patients decreased after inpatient therapy (from 13.08 to 6.94). The mean SF-36 value of all subscales for all patients increased after inpatient therapy except for general health subscale of SF-36. The regression analysis showed significant effect of age, being previously hospitalized, duration of admission on the DLQI scores. While age and being previously hospitalized were the factors to affect some of the SF-36 subscale scores.
Conclusion: Our results indicate that inpatient therapy may improve QOL of patients with dermatological diseases and that clinicians should consider assessment of DLQI to determine the therapy option for a patient.
References
Schmitt J, Heese E, Wozel G, Meurer M. Effectiveness of inpatient treatment on quality of life and clinical disease severity in atopic dermatitis and psoriasis vulgaris -a prospective study. Dermatology 2007; 214: 68-76.
Ayyalaraju RS, Finlay AY, Dykes PJ, Trent JT, Kirsner RS, Kerdel FA. Hospitalization for severe skin disease improves quality of life in the United Kingdom and the United States: a comparative study. J Am Acad Dermatol 2003; 49: 249-54.
Wahl AK, Mørk C, Lillehol BM, Myrdal AM, Helland S, Hanestad BR, Moum T. Changes in quality of life in persons with eczema and psoriasis after treatment in departments of dermatology. Acta Derm Venereol 2006; 86: 198-201.
Zachariae R, Zachariae C, Ibsen H, Mortensen JT, Wulf HC. Dermatology life quality index: data from Danish inpatients and outpatients. Acta Derm Venereol 2000; 80: 272-6.
Kurwa HA, Finlay AY. Dermatology inpatient management greatly improves life quality. Br J Dermatol 1995; 133: 575–8.
Helbling I, Muston HL, Ferguson JE, McKenna M. Audit of admissions to dermatology beds in Greater Manchester. Clin Exp Dermatol 2002; 27: 519-22.
Mazzotti E, Barbaranelli C, Picardi A, Abeni D, Pasquini P. Psychometric properties of the Dermatology Life Quality Index (DLQI) in 900 Italian patients with psoriasis. Acta Derm Venereol 2005; 85: 409-13.
Ayyalaraju RS, Finlay AY. Inpatient dermatology. United Kingdom and United States similarities: moving with the times or being relegated to the back bench? Dermatol Clin 2000; 18: 397-404.
Kirsner RS, Yang DG, Kerdel FA. Inpatient dermatology. The difficulties, the reality, and the future. Dermatol Clin 2000; 18: 383-90.
Vensel E, Hilley T, Trent J, Taylor JR, Kirsner RS, Kerdel FA, et al. Sustained improvement of the quality of life of patients with psoriasis after hospitalization. J Am Acad Dermatol 2000; 43: 858-60.
Zachariae R, Zachariae C, Ibsen HH, Mortensen JT, Wulf HC.. Psychological symptoms and quality of life of dermatology outpatients and hospitalized dermatology patients. Acta Derm Venereol 2004; 84: 205-12.
Hurwitz D, Kerdel FA, Kirsner RS. Hospitalization for skin disease improves quality of life. Arch Dermatol 1997; 133: 797-8.
Nijsten T. Dermatology life quality index: time to move forward. J Invest Dermatol. 2012; 132: 11-3.
Lundberg L, Johannesson M, Silverdahl M, Hermansson C, Lindberg M. Health-related quality of life in patients with psoriasis and atopic dermatitis measured with SF-36, DLQI and a subjective measure of disease activity. Acta Derm Venereol 2000; 80: 430-4.
Hongbo Y, Thomas CL, Harrison MA, Salek MS, Finlay AY. Translating the science of quality of life into practice: What do dermatology life quality index scores mean? J Invest Dermatol 2005; 125: 659-64.
De Korte J, Mombers FM, Sprangers MA, Bos JD. The Suitability of quality-of-life questionnaires for psoriasis research: a systematic literature review. Arch Dermatol 2002; 138: 1221-7.
Finlay AY. Quality of life indices. Indian J Dermatol Venereol Leprol 2004; 70: 143-8.
Basra MK, Chowdhury MM, Smith EV, Freemantle N, Piguet V. A review of the use of the dermatology life quality index as a criterion in clinical guidelines and health technology assessments in psoriasis and chronic hand eczema. Dermatol Clin. 2012; 30: 237-44.
Finlay AY, Khan GK. Dermatology life quality index (DLQI)-a simple practical measure for routine clinical use. Clin Exp Dermatol 1994; 19: 210-6.
Oztürkcan S, Ermertcan AT, Eser E, Sahin MT. Cross validation of the Turkish version of dermatology life quality index. Int J Dermatol 2006; 45: 1300-7.
Rapp SR, Feldman SR, Exum ML, Fleischer AB Jr, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol 1999; 41: 401-7.
Koçyiğit H, Aydemir Ö, Ölmez N. Kısa Form-36 (KF-36)’nın Türkçe Versiyonunun Güvenilirliği ve Geçerliliği. İlaç ve Tedavi Dergisi 1999; 12: 102–6.
Mazzotti E, Picardi A, Sampogna F, Sera F, Pasquini P, Abeni D. Sensitivity of the dermatology life quality index to clinical change in patients with psoriasis. Br J Dermatol 2003; 149: 318-22.
Wyrwich KW, Nienaber NA, Tierney WM, Wolinsky FD. Linking clinical relevance and statistical significance in evaluating intra-individual changes in health-related quality of life. Med Car 1999; 37: 469-78.
Katugampola RP, Hongbo Y, Finlay AY. Clinical management decisions are related to the impact of psoriasis on patient-rated quality of life. Br J Dermatol 2005; 152:1256-62.
Schmitt J, Küster D. Correlation between Dermatology Life Quality Index (DLQI)scores and Work Limitations Questionnaire (WLQ) allows the calculation of percent work productivity loss in patients with psoriasis. Arch Dermatol Res 2015; 307: 451-3.
Çakmur H, Derviş E. The relationship between quality of life and the severity of psoriasis in Turkey. Eur J Dermatol 2015; 25: 169-76.
Altunay IK, Atis G, Esen K, Kucukunal A. Impact of functional pruritus compared with mild psoriasis on quality of life: a cross-sectional questionnaire study in Turkey. Am J Clin Dermatol 2014; 15: 365-70.
Uçmak D, Akkurt M, Toprak G, Yesilova Y, Turan E, Yıldız I. Determination of dermatology life quality index, and serum C-reactive protein and plasma interleukin-6 levels in patients with chronic urticaria. Postepy Dermatol Alergol 2013; 30: 146-51.
Aksoy B, Altaykan-Hapa A, Egemen D, Karagöz F, Atakan N. The impact of rosacea on quality of life: effects of demographic and clinical characteristics and various treatment modalities. Br J Dermatol 2010; 163: 719-25.
