A Comprehensive Conceptual Model of the Experience of Chronic Itch in Adults

Silverberg, Jonathan I.; Kantor, Robert; Dalal, Pranav; Hickey, Catherine; Shaunfield, Sara; Kaiser, Karen; Lai, Jin Shei; Cella, David

doi:10.1007/s40257-018-0381-6

Cited by 49 publications

(41 citation statements)

References 26 publications

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“…PIQ items were developed and content validity was established as part of a broader conceptual model of itch using mixed methods, including systematic review ( n = 491 manuscripts) and semistructured interviews ( n = 33 adults with chronic itch with multiple aetiologies as previously described) 8. After item development, content validity was confirmed in AD using cognitive debriefing interviews in five adults with AD (Table 1 and File S1; see Supporting Information).…”

Section: Methodsmentioning

confidence: 99%

Measurement properties of the Patient‐Reported Outcomes Information System (PROMIS^®) Itch Questionnaire: itch severity assessments in adults with atopic dermatitis*

et al. 2020

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Summary Background Little is known about the validity of numeric rating scales (NRS) and verbal rating scales (VRS) for itch and itch frequency for assessing itch severity in atopic dermatitis (AD). We evaluated the Patient‐Reported Outcomes Information System (PROMIS®) Itch Questionnaire (PIQ) – itch severity assessment, including multiple NRS, VRS and frequency of itch assessments, in adults with AD and compared their performance. Methods Self‐administered questionnaires and skin examinations were performed in 410 patients with AD (aged 18–90 years) in a dermatology practice setting. Results PIQ NRS, VRS and frequency of itch had good content validity, strong correlations with one another (Spearman correlations P < 0·001) and weak‐to‐moderate correlations with patient‐oriented eczema measure (POEM), Eczema Area and Severity Index (EASI), objective SCORing AD (SCORAD) and Dermatology Life Quality Index (DLQI) (P < 0·001) and very good discriminant validity. Changes from baseline in NRS, VRS and frequency of itch were moderately to strongly correlated with one another, and weakly to moderately correlated with other patient‐reported (POEM, SCORAD itch, DLQI) and clinician‐reported outcomes (EASI, objective SCORAD). NRS and VRS worst itch and average itch showed moderate‐to‐good test–retest reliability. There were no floor or ceiling effects for NRS or VRS itch, but there were ceiling effects for itch frequency. Each assessment was completed in < 1 min by all patients. Conclusions NRS, VRS and frequency of itch items from PIQ – itch severity showed good content and construct validity, reliability, and/or responsiveness in adults with AD, and were feasible for use in clinical trials and practice. What is already known about this topic? Numeric rating scales (NRS), verbal rating scales (VRS) and frequency of itch have been used to assess the burden of itch. However, there have been limited results demonstrating their validity, responsiveness, interpretability and feasibility, particularly in atopic dermatitis (AD). What does this study add? This study demonstrated that NRS, VRS and frequency of itch items from the Patient‐Reported Outcomes Information System (PROMIS®) Itch Questionnaire (PIQ) – itch severity assessments had good construct validity, responsiveness, reliability and feasibility in the assessment of adult AD. PIQ NRS, VRS and frequency of itch all appear to have sufficient validity, reliability and feasibility for use as assessments of itch in adults with AD in clinical practice and trials. What are the clinical implications of this work? PIQ NRS and VRS are all simple, valid, reliable and feasible for use in clinical practice and trials to assess itch in adults with AD. Linked Comment: Oosterhaven. Br J Dermatol 2020; 183:802–803.

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Section: Methodsmentioning

confidence: 99%

Measurement properties of the Patient‐Reported Outcomes Information System (PROMIS^®) Itch Questionnaire: itch severity assessments in adults with atopic dermatitis*

et al. 2020

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“…5 Itch is a burdensome symptom with complex interactions between disease-specific and environmental factors and baseline characteristics. 16 Many adults with AD reported that AD limited their lifestyle (51.3%), caused them to avoid social interaction (39.1%), and impacted their activities (43.3%); they had only fair or poor overall health (25.8%) and were somewhat or very dissatisfied with life (16.7%). 5 These effects occurred even in mild AD, but even more so in moderate and severe AD.…”

Section: Burden Of Admentioning

confidence: 99%

Comorbidities and the impact of atopic dermatitis

Silverberg

2019

Annals of Allergy, Asthma & Immunology

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294

209

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Atopic dermatitis (AD) impacts all aspects of patients' quality of life and emotional well-being. Atopic dermatitis has a complex relationship with atopic comorbidities, including asthma, food allergy, and eosinophilic esophagitis. Atopic dermatitis is associated with symptoms of anxiety and depression, which are highly correlated with severity of AD signs and symptoms. Atopic dermatitis is associated with multiple cutaneous and extracutaneous infections of bacterial, mycobacterial, viral, and fungal origins. Atopic dermatitis is associated with increased cardiovascular risk factors, and potentially with cardiovascular disease and events.

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“…Although conceptual models detailing pediatric AD and pruritus exist in the published literature, to our knowledge, this study was the first of its kind to explore the lived experience of AD in both adult and adolescent patients. 16,17 In addition, to our knowledge, this is the first qualitative study to document the lived experience of AD in adolescents separately from other pediatric populations. Typically, research with adolescents (aged 11–17 years) is combined with that with younger pediatric patients (aged 0–10 years), for whom the HRQoL implications of AD are quite different.…”

Section: Discussionmentioning

confidence: 99%

Conceptual Model to Illustrate the Symptom Experience and Humanistic Burden Associated With Atopic Dermatitis in Adults and Adolescents

Grant¹,

Larsen

Trennery³

et al. 2019

Dermatitis

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A Comprehensive Conceptual Model of the Experience of Chronic Itch in Adults

Abstract: Our conceptual model demonstrates the profound patient-burden of itch and identifies unmet needs in the evaluation and management of itch.

Cited by 49 publications

References 26 publications

Measurement properties of the Patient‐Reported Outcomes Information System (PROMIS^®) Itch Questionnaire: itch severity assessments in adults with atopic dermatitis*

Measurement properties of the Patient‐Reported Outcomes Information System (PROMIS^®) Itch Questionnaire: itch severity assessments in adults with atopic dermatitis*

Comorbidities and the impact of atopic dermatitis

Conceptual Model to Illustrate the Symptom Experience and Humanistic Burden Associated With Atopic Dermatitis in Adults and Adolescents

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A Comprehensive Conceptual Model of the Experience of Chronic Itch in Adults

Abstract: Our conceptual model demonstrates the profound patient-burden of itch and identifies unmet needs in the evaluation and management of itch.

Cited by 49 publications

References 26 publications

Measurement properties of the Patient‐Reported Outcomes Information System (PROMIS®) Itch Questionnaire: itch severity assessments in adults with atopic dermatitis*

Measurement properties of the Patient‐Reported Outcomes Information System (PROMIS®) Itch Questionnaire: itch severity assessments in adults with atopic dermatitis*

Comorbidities and the impact of atopic dermatitis

Conceptual Model to Illustrate the Symptom Experience and Humanistic Burden Associated With Atopic Dermatitis in Adults and Adolescents

Contact Info

Product

Resources

About

Measurement properties of the Patient‐Reported Outcomes Information System (PROMIS^®) Itch Questionnaire: itch severity assessments in adults with atopic dermatitis*

Measurement properties of the Patient‐Reported Outcomes Information System (PROMIS^®) Itch Questionnaire: itch severity assessments in adults with atopic dermatitis*