Development and Preliminary Validation of the HSQoL-24 Tool to Assess Quality of Life in Patients With Hidradenitis Suppurativa

INTRODUCTION AND OBJECTIVES

Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin with a negative impact on quality of life. Up to now, there are no disease specific instruments in Spanish to assess quality of life in HS. The objective of this study was to develop and validate a questionnaire to evaluate the quality of life in patients with HS.

MATERIAL AND METHODS

A multicentre study was carried out in Spain between 2016 and 2017 to develop the questionnaire. Both the conceptual framework and understanding of the patient's situation were considered through a review of the literature, consensus of professionals from different related health areas, and in-depth interviews with patients. The resulting questionnaire was passed to a group of 30 patients with 30±10 days of interval between both assessments.

RESULTS

The reliability analysis shows a good internal consistency and reproducibility with Cronbach's alpha score of 0.920 (test) and 0.917 (retest) and intraclass correlation coefficient with DLQI and Skindex-29 of 0.698 IC 95% (0.456-0.844) and 0.900 IC 95% (0.801-0.951) respectively. Cut-off points were established for its use and the instrument was found to be sensitive to change.

CONCLUSIONS

The HSQoL-24 is the first disease-specific self-administered instrument to assess quality of life in patients with HS in Spanish. It is user friendly, and easy to score. This study shows that the instrument is reliable, valid and sensitive to change, pending confirmatory study with a larger sample of 100 patients with HS.

Intervención socio-emocional en el trastorno de hiperactividad con déficit de atención

El Trastorno por Déficit de Atención e Hiperactividad (TDAH) es el trastorno más frecuentemente diagnosticado durante la infancia. Uno de los modelos explicativos es el desarrollado por Barkley (1990), que considera que la capacidad de inhibición de una respuesta estaría mediatizada por la capacidad de inhibir una respuesta hacia un objeto que atrae nuestra atención, la capacidad para interrumpir una conducta que se está llevando a cabo y la competencia para cambiar el foco de nuestra atención. De esta forma, una baja capacidad de inhibición repercutiría negativamente en las capacidades cognitivas. Desde este modelo, se considera que dicha incapacidad de inhibición está producida por una alteración en la Función Ejecutiva. La muestra de nuestro estudio está formada un grupo de 25 niños con edades comprendidas entre 8 y 12 años diagnosticados de déficit de atención que no están tomando medicación en la actualidad ni la han tomado anteriormente. Se realizó un programa de intervención socio-emocional de una duración de 8 semanas y una frecuencia semanal de una hora. Durante estas sesiones se trabajó el autocontrol, la tolerancia a la frustración y la resiliencia. Los resultados muestran una mejora en la Función Ejecutiva que se traducían en una mejor inhibición conductual.

The burden of common skin diseases assessed with the EQ5D™: a European multicentre study in 13 countries

BACKGROUND

Generic instruments measuring health-related quality of life (HRQoL), like EQ5D™, enable comparison of skin diseases with healthy populations and nondermatological medical conditions, as well as calculation of utility data.

OBJECTIVES

To measure HRQoL in patients with common skin diseases and healthy controls across Europe using the EQ5D.

METHODS

This multicentre observational cross-sectional study was conducted in 13 European countries. Each dermatology clinic recruited at least 250 consecutive adult outpatients to complete questionnaires, including the EQ5D.

RESULTS

There were 5369 participants (4010 patients and 1359 controls). Mean ± SD self-rated health state reported by patients was 69·9 ± 19·7; for controls it was 82·2 ± 15·5. When adjusted for confounding factors, including comorbidity, mean patient EQ visual analogue scores were 10·5 points lower than for controls (standardized β = -0·23). Odds ratio with 95% confidence interval for impairment in all five dimensions of EQ5D adjusted for confounders was doubled for patients compared with controls. Patients with hidradenitis suppurativa (HS), blistering conditions, leg ulcers, psoriasis and eczemas had the highest risk for reduction in HRQoL in most dimensions (2-10-fold). Data on differences of impairment by dimensions offer new insights.

CONCLUSIONS

This study confirms the large impact skin conditions have on patients' well-being, differentiating between aspects of HRQoL. Patients with HS, blistering diseases, leg ulcers, infections and most chronic skin diseases reported reduced HRQoL compared with patients with chronic obstructive lung disease, diabetes mellitus, cardiovascular disease and cancers. These findings are important in the prioritization of resource allocation between medical fields and within dermatological subspecialities.