Estimating the Burden of Skin Diseases Using Patient-Reported Daily Time Trade-Off as a Measure of Disease Impact and Unmet Needs

January 2024 in “ JEADV Clinical Practice ”

Y.M.F. Andersen, Claus Zachariae, Simon Francis Thomsen, Jacob P. Thyssen, Alexander Egeberg

Alopecia Areata Hidradenitis Suppurativa Atopic Dermatitis psoriasis rosacea daily Time Trade-Off dTTO Dermatology Life Quality Index DLQI AA HS AD

TLDR Patients with certain skin diseases are willing to spend significant time on treatment, indicating a high impact on their lives and a need for better treatments.

The study involved 6258 patients with five different skin diseases: Alopecia Areata (AA), Hidradenitis Suppurativa (HS), Atopic Dermatitis (AD), psoriasis, and rosacea. It used a measure called daily Time Trade-Off (dTTO) to assess how much time patients are willing to spend on treatment for freedom from disease. The study found that 33.7% of AA patients and 29.3% of HS patients were willing to spend 2 hours or more per day on treatment, indicating a high disease burden and unmet treatment needs. Disease severity and Dermatology Life Quality Index (DLQI) were significant predictors for dTTO across all diseases. In AA patients, female gender was a strong predictor for a dTTO of more than 30 minutes, possibly due to the impact of hair loss on women's appearance and self-esteem. Socioeconomic status was not a significant predictor, suggesting that income did not majorly impact reported dTTO. The study had limitations including potential selection bias and lack of objective measures of disease severity.