Comparative Analysis of Patient-Reported Outcomes in Chronic Pruritus: Patients with Chronic Liver or Kidney Diseases Exhibit Higher Psychological Distress than Those with Atopic Dermatitis

慢性瘙痒症患者报告结局的比较分析:慢性肝病或肾病患者的心理压力高于特应性皮炎患者

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Abstract

INTRODUCTION: Chronic pruritus (CP; lasting ≥ 6 weeks) is a prevalent symptom with diverse underlying conditions, including chronic liver diseases (CLD), chronic kidney diseases (CKD) and atopic dermatitis (AD). CP is linked to a substantial physical, psychological and socioeconomic burden. Despite guideline-recommend therapies, there remains a lack of comprehensive understanding regarding the specific needs, treatment goals and patient-reported outcomes (PRO) of patients with CP across these aetiologies. METHODS: To address this gap, this retrospective cohort study analysed anonymized electronic health records from a specialized pruritus centre in Germany, focusing on three matched sub-cohorts, which were compiled from a total cohort of 1998 patients with CLD, CKD and AD to systematically compare disease burden, and treatment priorities. RESULTS: Patients with CLD and CKD exhibited significantly higher psychological distress compared to patients with AD, while patients with AD demonstrated greater quality of life impairment. Treatment goals were largely aligned across all patient groups, with symptom relief, diagnostic clarity and confidence in therapy emerging as top priorities. Significant correlations between patient needs, QoL impairment, levels of anxiety and depression and pruritus intensity were observed across all sub-cohorts. CONCLUSIONS: These results highlight the need for holistic, patient-centred management strategies that address both the physical and psychological aspects of CP.

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