Estimating the burden of skin diseases using patient‐reported daily time trade‐off as a measure of disease impact and unmet needs

Background: Dermatological diseases may cause significantly impairedquality of life, however patient reported outcomes are often disease specific,and not comparable across diseases.Objectives: To examine daily time trade‐off (dTTO), as a measure of diseaseburden.Methods: An epidemiological study based on patient data from Danish SkinCohort (prospective cohort of Danish dermatology patients) was conducted.Data were linked with routinely collected data from Statistics Denmark. Weincluded adults with either alopecia areata (AA), atopic dermatitis (AD),hidradenitis suppurative (HS), psoriasis, or rosacea. All patients with adiagnostic code listed above were invited to participate. The primary outcomewas defined as a dTTO of more than 30 minutes daily.Results: A total of 680, 1605, 611, 1664, and 1698 adults with AA, AD, HS,psoriasis, and rosacea, respectively, were included. In multiple regressionmodels, patients with AA were most likely to have a dTTO of more than 30minutes, followed by patients with HS, AD, psoriasis and rosacea. A total of33.7% (AA), 29.3% (HS), 14.6% (AD), 11.1% (psoriasis), and 9.0% (rosacea) ofpatients were willing to spend two hours or more per day. The dTTOcorrelated with disease severity and DLQI across disease groups.Conclusions: Patients with AA, followed by HS were willing to spend mosttime on treatment, possibly reflecting unmet needs in these patient groups.Daily TTO correlated with perceived disease severity in all groups and may bea useful measure of dermatological disease burden.