To describe consultation patterns, management and clinical characteristics of US refractory/non-refractory Chronic Idiopathic Urticaria (CIU) patients as reported by patients in a real world setting.
97 refractory/47 non-refractory CIU patients consulting US specialists (15 allergists/2 dermatologists) completed a patient questionnaire. Refractory was pre-defined as currently symptomatic/receiving higher dose/treatment beyond second-generation antihistamine monotherapy; non-refractory was pre-defined as receiving second-generation antihistamine monotherapy only. Ethical approval was obtained. Patient groups were compared using bivariate analysis. T-tests were used for continuous variables; Chi-squared or Fisher’s exact tests for categorical variables.
Compared with non-refractory patients, OTC self-medication is more common among refractory patients (74% vs 60%) and they are more likely to initially consult a PCP than a specialist (40% vs 31%), report delayed diagnosis due to referral (51% vs 33%) and forget to take their medication to some extent (50% vs 34%). They are significantly less likely to consult for every symptomatic period (12% vs 32%, p=0.01997) and report lower quality of life - Dermatology Quality of Life Index (7.0 vs 5.0); Jenkins Sleep Questionnaire score (8.1 vs 7.2).
On a 10-point attitudinal scale (where 0 = completely disagree/10 = completely agree), refractory patients report more concern about impact of their lifestyle on their condition (3.3 vs 2.1; p=0.045) and about treatment side effects (3.2 vs 1.7; p=0.008).
Distinct managerial, clinical, QoL and attitudinal differences exist between refractory and non-refractory CIU patients in the US. This information is valuable in informing best clinical practice and appropriate new interventions for both patient types.