Tom C. Chan, Yi-Chun Lin, Yung-Tsu Cho, Chao-Hsiun Tang, Chia-Yu Chu
DOI: 10.2340/00015555-3918

Atopic dermatitis has a substantial impact on work and activity impairment according to studies from Western communities. Prospective studies of work productivity and activity impairment in Asian patients with atopic dermatitis are lacking. The aims of this study were to investigate the impacts of atopic dermatitis on work productivity and activity impairment among Taiwanese patients, and to stratify the analyses by disease severity. One-third of employed participants reported missing work (absenteeism) in the preceding week due to atopic dermatitis, while 88.5% of the remaining two-thirds reported impaired work effectiveness (presenteeism). In addition, 92.5% of all participants reported impaired daily activities. Overall work impairment (aggregate productivity loss from absenteeism and presenteeism) was 1.8- and 2.6-fold greater in subjects with moderate and severe atopic dermatitis, respectively, compared with those with mild atopic dermatitis. Presenteeism, but not absenteeism, contributes to the majority of total work impairment in this cohort. Daily activity impairment was 1.5-fold greater in moderate atopic dermatitis, and 2.0-fold greater in severe atopic dermatitis, compared with mild atopic dermatitis. Both work and activity impairment showed significant positive correlations with atopic dermatitis severity scores (SCORing Atopic Dermatitis; SCORAD). In conclusion, work productivity and activity impairment is significantly correlated with disease severity in this Taiwanese atopic dermatitis cohort. In order to obtain a full picture of disease burden to patients and caregivers, patients with atopic dermatitis should be monitored for disease activity as well as corresponding impacts on quality of life.

Pruritus and the negative effect on appearance due to atopic dermatitis have a considerable impact on affected individuals, leading to substantial impairments in work and daily activity. Through analysis of work productivity and activity impairment in patients with atopic dermatitis, the current study demonstrated that presenteeism has a far greater impact on atopic dermatitis-related productivity loss than does absenteeism. Interventions aiming to reduce productivity loss due to atopic dermatitis should prioritize addressing presenteeism-induced work impairment. Detailed work productivity and activity impairment scores could change how health systems and policymakers engage in improving care for patients with atopic dermatitis.