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Stop the Itch! Evaluating Patient Needs in Chronic Pruritus

Chronic pruritus (CP) affects about 30% of all dermatology patients and satisfying patient needs with respect to treatment and diagnosis is often difficult. Patients also report varied quality of life (QoL) effects ranging from sleep disturbance to impairment in working life and everyday activities. Due to these variations, patient-reported outcomes research strongly recommends measuring the effect of health services from the patient’s perspective.

A recent study sought to analyze therapeutic needs and treatment goals in a large sample of patients using the Patient Needs Questionnaire (PNQ) of the validated Patient Benefit Index-Pruritus (PBI-P). Previous research has shown that there would be differences between CP populations depending on patient sex and clinical phenotype. The survey instrument measures the importance of 27 patient needs in terms of treatment goals using a five-point scale. Patients’ QoL was assessed with the Dermatological Life Quality Index (DLQI) and also completed the Hospital Anxiety and Depression Scale to assess psychological symptoms of depression and anxiety.

The results show that the most important treatment goal was “to find a clear diagnosis and therapy,” followed by the needs “to no longer experience itching” and “to have confidence in the therapy.” Needs did vary between the sexes with women reporting goals “to no longer have a burning sensation on the skin” or “to be able to wear all types of clothing” higher than men, and men rated goals “to be able to have more contact with other people” or “to be able to have a normal sex life” higher than women. There were also differences depending on whether the patients had inflamed skin or lesions.

The authors conclude that overall patient need level seems higher than in other dermatological patients. Symptom relief and treatments made up the most important needs. There is some differentiation in needs according to the clinical phenotype and to sex-specific aspects, as well as due to age, pruritus intensity and QoL. The authors state that possible burden in social life, as well as impairments due to therapy, should be particularly addressed in patients with CP on inflamed skin or with chronic scratch lesions.


Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: April 10, 2017

Source: Wiley Online Library
Adapted from the original article.

[Image: Shutterstock]

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