P52 The Dermatology Life Quality Index in 70 guidelines and 38 registries: a systematic review involving 55 countries: the International Standard of Care in Dermatology
Annabelle Xiao Hui Lim, Jeffrey Johns, Jui Vyas, Faraz M Ali, John R Ingram, Muaad Eghlileb, Alison K Y Chao, Sam Salek, Andrew Y FinlayAbstract
Introduction and aims
The Dermatology Life Quality Index (DLQI) is the most widely used instrument to measure the impact of skin conditions on patients’ quality of life (QoL) in routine practice and to inform clinical decision making. This study aimed to systematically review publications using DLQI data from dermatology registries and from its use in dermatology guidelines.
Methods
A systematic search of MEDLINE, Embase and Scopus identified articles describing registries collecting routine clinical data and guidelines incorporating the DLQI in clinical decision making. Additionally, national and regional dermatology organizations were surveyed to determine the use of the DLQI in guidelines and registries, and websites of English language organizations that included dermatological guidelines were screened.
Results
Of 2593 publications identified, 195 met inclusion criteria. Overall, 56 studies from 55 different countries referenced both ‘DLQI’ and ‘dermatological guidelines’, while 123 studies used DLQI data from 59 registries. Twenty were generic publications referring to guidelines or registries and the DLQI, and two were guideline adaptations. Over half of studies using guidelines (29/55, 53%) focused on psoriasis, 21% atopic dermatitis/eczema, 12% hidradenitis suppurativa, 11% urticaria, 7% alopecia, 4% rosacea and 4% acne, and 2% each for bullous disease, cellulitis, actinic keratosis, vitiligo and psoriasis with psoriatic arthritis. Studies used data from 37 different registries where diseases studied were psoriasis (73/120 studies, 59.3%), atopic dermatitis (15.8%), psoriasis and psoriatic arthritis (9.2%), eczema (5.0%), psoriatic arthritis (3.3%), hidradenitis suppurativa (1.7%) and urticaria (1.7%) and 1 study each (0.8%) with alopecia, lupus erythematosus, palmoplantar pustulosis and pemphigus. Overall, 59 registries were authored by dermatology groups, e.g. British Association of Dermatologists Biologic Interventions Register, 29 by governments, 9 by pharmaceutical companies,10 by trusts/foundations and 2 by societies.
Conclusions
There is accumulating evidence of the application of the DLQI in registries and clinical and reimbursement guidelines. The uniform use of DLQI in multiple registries internationally contributes to improved global health and facilitates meaningful comparison of QoL data.