Atopic dermatitis (AD) is a chronic inflammatory skin disease, and prevalence rates have increased in most countries across Europe |
Although prior studies using data from the National Health and Wellness Survey have described the burden of moderate-to-severe AD, data assessing the impact of mild-to-moderate AD are limited |
The objective of this study was to describe the clinical and humanistic burden of AD in Europe across severity levels, including also milder forms of this chronic disease |
Respondents with mild-to-moderate AD had a higher burden of comorbidities, sleep difficulties, and psychological disorders (anxiety and depression) and poorer quality of life/functional status, work productivity, and activity levels compared with non–AD-matched controls. Additionally, the most common comorbidities observed in milder patients were consistent with those also found to be the most common in more severe AD |
Results from this study highlight the importance of improving disease management across patients with varying levels of severity, including patients with only mild disease |
Introduction
Methods
Study Design and Population
Assessments and Outcomes
Statistical Analysis
Results
Population
AD cohort | Matched non-AD control cohort | P valuea | ||||
---|---|---|---|---|---|---|
Mild AD | Moderate AD | Severe AD | Total | N = 4208 | ||
n = 2862 | n = 1177 | n = 169 | N = 4208 | |||
Age, mean (range), years | 46.0 (18–88) | 45.0 (18–91) | 41.5 (18–87) | 45.6 (18–91) | 45.6 (18–93) | 0.85 |
Female, n (%) | 1901 (66.4) | 842 (71.5) | 121 (71.6) | 2864 (68.1) | 2870 (68.2) | 0.89 |
Geographic location, n (%) | ||||||
UK | 1031 (36.0) | 342 (29.1) | 44 (26.0) | 1417 (33.7) | 1404 (33.4) | |
France | 710 (24.8) | 331 (28.1) | 56 (33.1) | 1097 (26.1) | 1151 (27.4) | 0.66 |
Spain | 445 (15.6) | 181 (15.4) | 26 (15.4) | 652 (15.5) | 654 (15.5) | |
Germany | 418 (14.6) | 171 (14.5) | 22 (13.0) | 611 (14.5) | 577 (13.7) | |
Italy | 258 (9.0) | 152 (12.9) | 21 (12.4) | 431 (10.2) | 422 (10.0) | |
Employed, n (%) | 1577 (55.1) | 646 (54.9) | 92 (54.4) | 2315 (55.0) | 2424 (57.6) | 0.02 |
Charlson comorbidity index, n (%) | ||||||
0 | 2372 (82.9) | 951 (80.8) | 134 (79.3) | 3457 (82.2) | 3533 (84.0) | |
1 | 301 (10.5) | 125 (10.6) | 18 (10.7) | 444 (10.6) | 413 (9.8) | 0.13 |
2 | 113 (4.0) | 68 (5.8) | 10 (5.9) | 191 (4.5) | 167 (4.0) | |
≥ 3 | 76 (2.7) | 33 (2.8) | 7 (4.1) | 116 (2.8) | 95 (2.3) | |
Other atopic condition (allergic rhinitis, asthma), n (%) | 1053 (36.8) | 449 (38.2) | 68 (40.2) | 1570 (37.3) | 1573 (37.4) | 0.95 |
Mild AD | Moderate AD | Severe AD | Total AD cohort | |
---|---|---|---|---|
N = 4208 | ||||
n = 2862 | n = 1177 | n = 169 | ||
Time since diagnosis, n (%) | ||||
< 5 years | 1001 (35.0) | 411 (34.9) | 62 (36.7) | 1474 (35.0) |
6–10 years | 353 (12.3) | 155 (13.2) | 24 (14.2) | 532 (12.6) |
11–15 years | 242 (8.5) | 96 (8.2) | 12 (7.1) | 350 (8.3) |
≥ 16 years | 1165 (40.7) | 490 (41.6) | 66 (39.1) | 1721 (40.9) |
Missing/unknown | 101 (3.5) | 25 (2.1) | 5 (3.0) | 131 (3.1) |
Diagnosing healthcare professional, n (%) | ||||
Primary care/general practice | 1484 (51.9) | 490 (41.6) | 65 (38.5) | 2039 (48.5) |
Dermatologist | 977 (34.1) | 512 (43.5) | 79 (46.8) | 1568 (37.3) |
Allergist | 90 (3.1) | 63 (5.4) | 7 (4.1) | 160 (3.8) |
Pediatrician | 93 (3.3) | 34 (2.9) | 7 (4.1) | 134 (3.2) |
Nurse practitioner/physician assistant | 68 (2.4) | 26 (2.2) | 3 (1.8) | 97 (2.3) |
Other | 49 (1.7) | 27 (2.3) | 3 (1.8) | 79 (1.9) |
Missing/unknown | 101 (3.5) | 25 (2.1) | 5 (3.0) | 131 (3.1) |
Self-reported severity, n (%) | ||||
Mild | 2862 (100) | – | – | 2862 (68.0) |
Moderate | – | 1177 (100) | – | 1177 (28.0) |
Severe | – | – | 169 (100) | 169 (4.0) |
AD location, n (%) | ||||
Hands | 941 (32.9) | 460 (39.1) | 73 (43.2) | 1474 (35.0) |
Face/neck | 835 (29.2) | 420 (35.7) | 72 (42.6) | 1327 (31.5) |
Lower arm | 706 (24.7) | 355 (30.2) | 72 (42.6) | 1133 (26.9) |
Lower leg | 687 (24.0) | 319 (27.1) | 54 (32.0) | 1060 (25.2) |
Upper arm | 562 (19.6) | 310 (26.3) | 63 (37.3) | 935 (22.2) |
Scalp/head | 546 (19.1) | 309 (26.3) | 45 (26.6) | 900 (21.4) |
Upper leg | 376 (13.1) | 239 (20.3) | 55 (32.5) | 670 (15.9) |
Feet | 387 (13.5) | 198 (16.8) | 43 (25.4) | 628 (14.9) |
Chest/torso | 353 (12.3) | 214 (18.2) | 42 (24.9) | 609 (14.5) |
Back | 297 (10.4) | 203 (17.3) | 36 (21.3) | 536 (12.7) |
Buttocks | 179 (6.3) | 138 (11.7) | 29 (17.2) | 346 (8.2) |
Other | 236 (8.3) | 104 (8.8) | 16 (9.5) | 356 (8.5) |
Over-the-counter treatment for AD, n (%) | ||||
Yes | 734 (25.7) | 359 (30.5) | 56 (33.1) | 1149 (27.3) |
No | 1688 (59.0) | 572 (48.6) | 86 (50.9) | 2346 (55.8) |
Missing/unknown | 440 (15.4) | 246 (20.9) | 27 (16.0) | 713 (16.9) |
Prescription treatment for AD, n (%) | ||||
Yes | 1202 (42.0) | 504 (42.8) | 74 (43.8) | 1780 (42.3) |
No | 1660 (58.0) | 673 (57.2) | 95 (56.2) | 2428 (57.7) |
Prescribing healthcare professional, n (%) | ||||
Primary care/general practice | 777 (27.2) | 256 (21.8) | 33 (19.5) | 1066 (25.3) |
Dermatologist | 326 (11.4) | 211 (17.9) | 37 (21.9) | 574 (13.6) |
Allergist | 32 (1.1) | 20 (1.7) | 2 (1.2) | 54 (1.3) |
Nurse practitioner/physician assistant | 30 (1.1) | 10 (0.9) | 1 (0.6) | 41 (1.0) |
Other | 37 (1.3) | 7 (0.6) | 1 (0.6) | 45 (1.1) |
DLQI, n (%) | ||||
No effect (0 or 1) | 1411 (49.3) | 269 (22.9) | 17 (10.1) | 1697 (40.3) |
Small effect (2–5) | 978 (34.2) | 470 (39.9) | 49 (29.0) | 1497 (35.6) |
Moderate effect (6–10) | 320 (11.2) | 240 (20.4) | 37 (21.9) | 597 (14.2) |
Very large effect (11–20) | 129 (4.5) | 166 (14.1) | 53 (31.4) | 348 (8.3) |
Extremely large effect (21–30) | 24 (0.8) | 32 (2.7) | 13 (7.7) | 69 (1.6) |
Comorbidity Burden
Mild-to-moderate AD | Matched non-AD control cohort | P valuea | Moderate-to-severe AD | Matched non-AD control cohort | P valuea | |
---|---|---|---|---|---|---|
N = 4039 | N = 4039 | N = 1346 | N = 1346 | |||
Comorbidity burden, n (%) | ||||||
Atopic comorbidities | ||||||
Allergies | 1713 (42.4) | 907 (22.5) | < 0.0001 | 654 (48.6) | 315 (23.4) | < 0.0001 |
Allergic rhinitis | 1040 (25.8) | 925 (22.9) | 0.0029 | 342 (25.4) | 307 (22.8) | 0.11 |
Asthma | 913 (22.6) | 796 (19.7) | 0.0014 | 327 (24.3) | 273 (20.3) | 0.012 |
Food allergies | 590 (14.6) | 229 (5.7) | < 0.0001 | 241 (17.9) | 92 (6.8) | < 0.0001 |
Cardiac, vascular, and metabolic comorbidities | ||||||
Hypertension | 852 (21.1) | 684 (16.9) | < 0.0001 | 291 (21.6) | 215 (16.0) | 0.0002 |
High cholesterol | 818 (20.3) | 612 (15.2) | < 0.0001 | 278 (20.7) | 186 (13.8) | < 0.0001 |
Angina | 452 (11.2) | 306 (7.6) | < 0.0001 | 162 (12.0) | 117 (8.7) | 0.0044 |
Type 2 diabetes | 261 (6.5) | 253 (6.3) | 0.72 | 91 (6.8) | 74 (5.5) | 0.17 |
Atrial fibrillation | 55 (1.4) | 51 (1.3) | 0.7 | 23 (1.7) | 18 (1.3) | 0.43 |
Heart attack | 60 (1.5) | 55 (1.4) | 0.64 | 26 (1.9) | 11 (0.8) | 0.013 |
Congestive heart failure | 44 (1.1) | 37 (0.9) | 0.43 | 19 (1.4) | 15 (1.1) | 0.49 |
Peripheral vascular disease | 24 (0.6) | 14 (0.4) | 0.1 | 13 (1.0) | 2 (0.2) | 0.0044 |
Stroke | 34 (0.8) | 35 (0.9) | 0.9 | 8 (0.6) | 12 (0.9) | 0.37 |
Neuropsychiatric comorbidities | ||||||
Pain | 1316 (32.6) | 878 (21.7) | < 0.0001 | 479 (35.6) | 315 (23.4) | < 0.0001 |
Migraine | 759 (18.8) | 484 (12.0) | < 0.0001 | 297 (22.1) | 173 (12.9) | < 0.0001 |
Attention deficit disorder | 38 (0.9) | 13 (0.3) | 0.0004 | 20 (1.5) | 6 (0.5) | 0.0058 |
Attention deficit hyperactivity disorder | 28 (0.7) | 11 (0.3) | 0.0064 | 17 (1.3) | 5 (0.4) | 0.01 |
Psychological burden, n (%) | ||||||
Anxiety | 1723 (42.7) | 1262 (31.3) | < 0.0001 | 629 (46.7) | 457 (34.0) | < 0.0001 |
Depression severity | ||||||
None-minimal (0–4) | 1866 (46.2) | 2277 (56.4) | < 0.0001 | 502 (37.3) | 715 (53.1) | < 0.0001 |
Mild (5–9) | 1123 (27.8) | 974 (24.1) | 406 (30.2) | 358 (26.6) | ||
Moderate (10–14) | 531 (13.2) | 433 (10.7) | 211 (15.7) | 152 (11.3) | ||
Moderately severe (15–19) | 329 (8.2) | 213 (5.3) | 139 (10.3) | 74 (5.5) | ||
Severe (20–27) | 190 (4.7) | 142 (3.5) | 88 (6.5) | 47 (3.5) | ||
Sleep burden, n (%) | ||||||
At least one sleep difficulty | 2065 (51.1) | 1563 (38.7) | < 0.0001 | 752 (55.9) | 528 (39.2) | < 0.0001 |
Severity of sleep difficulties | ||||||
Mild | 999 (24.7) | 818 (20.3) | < 0.0001 | 271 (20.1) | 273 (20.3) | < 0.0001 |
Moderate | 818 (20.3) | 576 (14.3) | 335 (24.9) | 202 (15.0) | ||
Severe | 248 (6.1) | 169 (4.2) | 146 (10.9) | 53 (3.9) | ||
Impact of sleep difficulties | ||||||
No impact | 209 (5.2) | 186 (4.6) | < 0.0001 | 69 (5.1) | 67 (5.0) | < 0.0001 |
Little impact | 568 (14.1) | 454 (11.2) | 164 (12.2) | 147 (10.9) | ||
Mild impact | 547 (13.5) | 414 (10.3) | 189 (14.0) | 137 (10.2) | ||
Moderate impact | 563 (13.9) | 405 (10.0) | 252 (18.7) | 134 (10.0) | ||
Severe impact | 178 (4.4) | 104 (2.6) | 78 (5.8) | 43 (3.2) | ||
SF-36v2 scores, mean (SD) | ||||||
Mental component summary score | 43.44 (10.70) | 45.70 (10.29) | < 0.0001 | 41.54 (10.35) | 45.34 (10.45) | < 0.0001 |
Physical component summary score | 48.96 (9.79) | 50.30 (9.36) | < 0.0001 | 47.74 (10.08) | 50.00 (9.38) | < 0.0001 |
Domain scores | ||||||
Bodily pain | 46.46 (10.37) | 48.35 (10.09) | < 0.0001 | 44.47 (10.76) | 47.90 (10.03) | < 0.0001 |
Vitality | 47.75 (9.57) | 49.55 (9.74) | < 0.0001 | 46.85 (9.71) | 49.34 (9.72) | < 0.0001 |
General health | 46.39 (10.20) | 48.13 (10.03) | < 0.0001 | 45.39 (10.55) | 47.94 (9.94) | < 0.0001 |
Physical functioning | 49.65 (9.55) | 50.90 (9.11) | < 0.0001 | 48.32 (10.08) | 50.47 (9.33) | < 0.0001 |
Physical role functioning | 46.17 (9.80) | 48.03 (9.47) | < 0.0001 | 44.51 (9.94) | 47.75 (9.48) | < 0.0001 |
Emotional role functioning | 42.93 (11.76) | 45.32 (11.38) | < 0.0001 | 40.63 (11.90) | 44.75 (11.52) | < 0.0001 |
Mental health | 44.81 (9.84) | 46.89 (9.74) | < 0.0001 | 43.13 (9.62) | 46.59 (9.89) | < 0.0001 |
Social functioning | 44.83 (10.12) | 46.74 (9.76) | < 0.0001 | 42.61 (10.14) | 46.37 (9.94) | < 0.0001 |
EQ-5D-5L scores, mean (SD) | ||||||
Index | 0.76 (0.23) | 0.81 (0.21) | < 0.0001 | 0.72 (0.27) | 0.81 (0.23) | < 0.0001 |
VAS | 69.51 (22.47) | 73.85 (21.61) | < 0.0001 | 65.48 (23.88) | 73.13 (21.65) | < 0.0001 |
Activity and work functioning burden, mean (SD) | ||||||
Activity impairmentb | 31.21 (29.16) | 25.79 (28.28) | < 0.0001 | 37.68 (30.00) | 27.85 (29.04) | < 0.0001 |
Work impairmentc | ||||||
Absenteeismd | n = 2053 | n = 2150 | < 0.0001 | n = 682 | n = 732 | < 0.0001 |
9.73 (23.49) | 6.88 (20.06) | 11.98 (24.79) | 7.09 (19.68) | |||
Presenteeisme | n = 1983 | n = 2097 | < 0.0001 | n = 655 | n = 720 | < 0.0001 |
23.44 (26.28) | 19.41 (25.02) | 29.85 (27.70) | 21.50 (26.00) | |||
Overall work impairmentf | n = 1970 | n = 2092 | < 0.0001 | n = 651 | n = 716 | < 0.0001 |
25.97 (28.80) | 21.37 (27.14) | 33.11 (30.43) | 23.50 (28.08) |
Psychological Burden
Sleep Difficulties
AD cohort N = 4208 | Matched non-AD control cohort N = 4208 | P valuea | |||
---|---|---|---|---|---|
Mild AD n = 2862 | Moderate AD n = 1177 | Severe AD n = 169 | |||
At least one sleep difficulty | 1418 (49.6) | 647 (55.0) | 105 (62.1) | 1636 (38.9) | < 0.0001 |
Severity of sleep difficulties | |||||
Mild | 758 (26.5) | 241 (20.5) | 30 (17.8) | 857 (20.4) | < 0.0001 |
Moderate | 524 (18.3) | 294 (25.0) | 41 (24.3) | 607 (14.4) | |
Severe | 136 (4.8) | 112 (9.5) | 34 (20.1) | 172 (4.1) | |
Impact of sleep difficulties | |||||
No impact | 151 (5.3) | 58 (4.9) | 11 (6.5) | 200 (4.8) | < 0.0001 |
Little impact | 423 (14.8) | 145 (12.3) | 19 (11.2) | 482 (11.5) | |
Mild impact | 376 (13.1) | 171 (14.5) | 18 (10.7) | 451 (10.7) | |
Moderate impact | 349 (12.2) | 214 (18.2) | 38 (22.5) | 392 (9.3) | |
Severe impact | 119 (4.2) | 59 (5.0) | 19 (11.2) | 111 (2.6) |
Quality of Life and Functional Status
AD cohort N = 4208 | Matched non-AD control cohort N = 4208 | P valuea | |||
---|---|---|---|---|---|
Mild AD n = 2862 | Moderate AD n = 1177 | Severe AD n = 169 | |||
EQ-5D-5L index | 0.78 (0.22) | 0.72 (0.26) | 0.67 (0.29) | 0.81 (0.22) | < 0.0001 |
EQ-5D-5L VAS | 70.91 (21.87) | 66.11 (23.55) | 61.11 (25.76) | 73.28 (21.93) | < 0.0001 |
Work Productivity
AD cohort | Matched non-AD control cohort | P valuea | |||
---|---|---|---|---|---|
Mild AD | Moderate AD | Severe AD | |||
N = 4208 | N = 4208 | ||||
n = 2862 | n = 1177 | n = 169 | |||
Activity impairmentb | 28.86 (28.52) | 36.94 (29.91) | 42.84 (30.18) | 26.76 (28.82) | < 0.0001 |
Work impairmentc | N = 2315 | N = 2424 | |||
n = 1577 | n = 646 | n = 92 | |||
Absenteeismd | 8.82 (22.80) | 11.95 (24.98) | 12.22 (23.60) | 7.08 (19.82) | < 0.0001 |
Presenteeisme | 21.25 (25.45) | 28.88 (27.49) | 36.43 (28.40) | 20.45 (25.98) | < 0.0001 |
Overall work impairmentf | 23.51 (27.79) | 32.02 (30.33) | 40.55 (30.24) | 22.45 (28.24) | < 0.0001 |
Sensitivity Analysis: Burden of AD per DLQI Bands
Mild-to-moderate AD (DLQI < 11) N = 3791 | Matched non-AD control cohort N = 3791 | P valuea | Moderate-to-severe AD (DLQI ≥ 6) N = 1014 | Matched non-AD control cohort N = 1014 | P valuea | |
---|---|---|---|---|---|---|
Comorbidity burden, n (%) | ||||||
Atopic comorbidities | ||||||
Allergies | 1577 (41.6) | 830 (21.9) | < 0.0001 | 535 (52.8) | 284 (28.0) | < 0.0001 |
Allergic rhinitis | 967 (25.5) | 840 (22.2) | 0.0006 | 281 (27.7) | 238 (23.5) | 0.03 |
Asthma | 836 (22.1) | 712 (18.8) | 0.0004 | 270 (26.6) | 224 (22.1) | 0.02 |
Food allergies | 520 (13.7) | 236 (6.2) | < 0.0001 | 214 (21.1) | 77 (7.6) | < 0.0001 |
Cardiac, vascular, and metabolic comorbidities | ||||||
Hypertension | 815 (21.5) | 674 (17.8) | < 0.0001 | 204 (20.1) | 122 (12.0) | < 0.0001 |
High cholesterol | 769 (20.3) | 548 (14.5) | < 0.0001 | 198 (19.5) | 148 (14.6) | 0.003 |
Angina | 424 (11.2) | 270 (7.1) | < 0.0001 | 129 (12.7) | 82 (8.1) | 0.0006 |
Type 2 diabetes | 244 (6.4) | 218 (5.8) | 0.21 | 61 (6.0) | 49 (4.8) | 0.24 |
Atrial fibrillation | 51 (1.4) | 44 (1.2) | 0.47 | 19 (1.9) | 11 (1.1) | 0.14 |
Heart attack | 55 (1.5) | 44 (1.2) | 0.27 | 16 (1.6) | 5 (0.5) | 0.02 |
Congestive heart failure | 37 (1.0) | 24 (0.6) | 0.09 | 17 (1.7) | 9 (0.9) | 0.11 |
Peripheral vascular disease | 19 (0.5) | 7 (0.2) | 0.02 | 9 (0.9) | 0 | 0.003 |
Stroke | 30 (0.8) | 32 (0.8) | 0.80 | 17 (1.7) | 2 (0.2) | 0.0005 |
Neuropsychiatric comorbidities | ||||||
Pain | 1214 (32.0) | 799 (21.1) | < 0.0001 | 396 (39.1) | 246 (24.3) | < 0.0001 |
Migraine | 690 (18.2) | 445 (11.7) | < 0.0001 | 260 (25.6) | 164 (16.2) | < 0.0001 |
Attention deficit disorder | 36 (1.0) | 16 (0.4) | 0.005 | 19 (1.9) | 6 (0.6) | 0.009 |
Attention deficit hyperactivity disorder | 27 (0.7) | 13 (0.3) | 0.03 | 18 (1.8) | 4 (0.4) | 0.003 |
Psychological burden, n (%) | ||||||
Anxiety | 1577 (41.6) | 1190 (31.4) | < 0.0001 | 534 (52.7)b | 341 (33.6) | < 0.0001 |
Depression severity | ||||||
None-minimal (0–4) | 1833 (48.4) | 2087 (55.1) | < 0.0001 | 245 (24.2)b | 509 (50.2) | < 0.0001 |
Mild (5–9) | 1060 (28.0) | 943 (24.9) | 324 (32.0)b | 256 (25.3) | ||
Moderate (10–14) | 476 (12.6) | 426 (11.2) | 204 (20.1)b | 130 (12.8) | ||
Moderately severe (15–19) | 264 (7.0) | 211 (5.6) | 149 (14.7)b | 75 (7.4) | ||
Severe (20–27) | 158 (4.2) | 124 (3.3) | 92 (9.1)b | 44 (4.3) | ||
Sleep burden, n (%) | ||||||
At least one sleep difficulty | 1900 (50.1) | 1466 (38.7) | < 0.0001 | 625 (61.6)b | 428 (42.2) | < 0.0001 |
Severity of sleep difficulties | ||||||
Mild | 936 (24.7) | 754 (19.9) | < 0.0001 | 242 (23.9)b | 223 (22.0) | < 0.0001 |
Moderate | 729 (19.2) | 559 (14.8) | 286 (28.2)b | 155 (15.3) | ||
Severe | 235 (6.2) | 153 (4.0) | 97 (9.6)b | 50 (4.9) | ||
Impact of sleep difficulties | ||||||
No impact | 199 (5.3) | 174 (4.6) | < 0.0001 | 48 (4.7)b | 48 (4.7) | < 0.0001 |
Little impact | 532 (14.0) | 439 (11.6) | 143 (14.1)b | 124 (12.2) | ||
Mild impact | 498 (13.1) | 378 (10.0) | 156 (15.4)b | 115 (11.3) | ||
Moderate impact | 511 (13.5) | 371 (9.8) | 206 (20.3)b | 105 (10.4) | ||
Severe impact | 160 (4.2) | 104 (2.7) | 72 (7.1)b | 36 (3.6) | ||
SF-36v2 scores, mean (SD) | ||||||
Mental component summary score | 43.89 (10.62) | 45.62 (10.23) | < 0.0001 | 39.15 (10.00) | 44.42 (10.18) | < 0.0001 |
Physical component summary score | 49.17 (9.81) | 50.30 (9.42) | < 0.0001 | 46.55 (9.80) | 50.08 (9.58) | < 0.0001 |
Domain scores | ||||||
Bodily pain | 46.85 (10.31) | 48.42 (10.09) | < 0.0001 | 42.22 (10.27) | 47.50 (10.52) | < 0.0001 |
Vitality | 47.80 (9.55) | 49.44 (9.70) | < 0.0001 | 46.72 (9.64) | 49.09 (9.99) | < 0.0001 |
General health | 46.45 (10.12) | 48.18 (10.00) | < 0.0001 | 44.82 (10.65) | 48.29 (9.97) | < 0.0001 |
Physical functioning | 49.93 (9.42) | 50.83 (9.21) | < 0.0001 | 47.12 (10.03) | 50.51 (9.49) | < 0.0001 |
Physical role functioning | 46.60 (9.69) | 47.93 (9.57) | < 0.0001 | 42.04 (9.62) | 47.09 (9.82) | < 0.0001 |
Emotional role functioning | 43.54 (11.57) | 45.25 (11.40) | < 0.0001 | 37.20 (11.57) | 43.89 (11.73) | < 0.0001 |
Mental health | 45.16 (9.77) | 46.82 (9.70) | < 0.0001 | 41.43 (9.40) | 45.83 (9.77) | < 0.0001 |
Social functioning | 45.42 (10.01) | 46.71 (9.85) | < 0.0001 | 39.45 (9.21) | 45.55 (9.88) | < 0.0001 |
EQ-5D-5L scores, mean (SD) | ||||||
Index | 0.77 (0.23) | 0.81 (0.22) | < 0.0001 | 0.68 (0.27) | 0.80 (0.23) | < 0.0001 |
VAS | 70.08 (22.31) | 73.34 (22.12) | < 0.0001 | 62.55 (23.32) | 72.71 (22.43) | < 0.0001 |
Activity and work functioning burden, mean (SD) | ||||||
Activity impairmentc | 29.80 (28.70) | 26.26 (28.64) | < 0.0001 | 44.83 (28.86) | 27.59 (28.88) | < 0.0001 |
Work impairmentd | ||||||
Absenteeisme | n = 1884 8.58 (22.86) | n = 1986 7.58 (21.31) | 0.16 | n = 574 15.58 (25.86) | n = 589 8.36 (21.33) | < 0.0001 |
Presenteeismf | n = 1820 21.20 (25.04) | n = 1940 20.25 (25.61) | 0.25 | n = 554 38.95 (27.60) | n = 573 21.38 (26.35) | < 0.0001 |
Overall work impairmentg | n = 1808 23.26 (27.22) | n = 1927 22.23 (27.95) | 0.25 | n = 549 43.66 (30.26) | n = 572 23.78 (29.03) | < 0.0001 |