University Medical Center Hamburg, Hamburg, Germany.
University Hospital of Brest, Brest, France.
J Eur Acad Dermatol Venereol. 2022 Jul;36 Suppl 7:3-16. doi: 10.1111/jdv.18168.
Atopic dermatitis (AD) is a chronic, auto-immune condition that imposes a high burden on individuals, society, and the healthcare system. Approximately 4.4% of adults and up to 18.6% of children/adolescents have AD in Europe, with 20% of all cases accounting for moderate-to-severe forms. This form of the condition in adults results in annual societal costs across Europe of an estimated €30 billion; €15.2 billion related to missed workdays or reduced work productivity, €10.1 billion related to direct medical costs and €4.7 billion related to personal expenditure of patients/families. AD can also substantially impact physical, emotional, and social quality-of-life. Several studies have shown the debilitating itch-scratch cycle is the main cause of the multifaceted burden, as it causes substantial sleep deprivation and stigmatisation due to the physical appearance of the skin, and confidence issues. These factors lead to psychosocial issues and can cumulate over time and prohibit patients reaching their 'full life potential'. Despite this, many patients with the condition are undertreated, resulting in uncontrolled symptoms and a further strain placed on patients, society, and the economy. The authors of this White Paper comprise the European Atopic Dermatitis Working Group, which is a network of international specialists with expertise in dermatology and healthcare policy decisions. Their programme of action is focused on harnessing their expertise to build consensus, advance research, share knowledge, and ultimately seek to improve AD care outcomes through achieving long-term symptom control. This White Paper presents a systematic evaluation of the overall financial and humanistic burden of moderate-to-severe AD and the current challenges that exist with AD care. It introduces recommendations for how, collaboratively, key stakeholders and policy makers can support improvements in AD management to achieve better disease control, thus reducing the costs and associated burden placed on individuals, society, and the economy.
特应性皮炎(AD)是一种慢性自身免疫性疾病,给个人、社会和医疗保健系统带来了沉重负担。欧洲约有 4.4%的成年人和高达 18.6%的儿童/青少年患有 AD,所有病例中有 20%为中重度。这种成人形式的疾病在欧洲造成的年度社会成本估计为 300 亿欧元;€152 亿欧元与工作日缺勤或工作效率降低有关,€101 亿欧元与直接医疗费用有关,€47 亿欧元与患者/家庭的个人支出有关。AD 还会严重影响身体、情感和社会生活质量。几项研究表明,使人衰弱的瘙痒-搔抓循环是造成多方面负担的主要原因,因为它会导致大量睡眠不足,并因皮肤外观和自信心问题而导致污名化。这些因素导致心理社会问题,并随着时间的推移累积,使患者无法充分发挥他们的“全部潜力”。尽管如此,许多患有该疾病的患者治疗不足,导致症状无法得到控制,给患者、社会和经济带来进一步的压力。本白皮书的作者组成了欧洲特应性皮炎工作组,这是一个由皮肤科和医疗保健政策决策方面的国际专家组成的网络。他们的行动计划重点是利用他们的专业知识建立共识、推进研究、分享知识,并最终通过实现长期症状控制来寻求改善 AD 护理结果。本白皮书系统评估了中重度 AD 的总体经济和人文负担以及 AD 护理目前存在的挑战。它提出了如何共同协作,让利益相关者和政策制定者支持 AD 管理的改进,以实现更好的疾病控制,从而降低个人、社会和经济的成本和相关负担的建议。