Jonathan I Silverberg1,2,3, Robert W Kantor4, Prarthana Dalal4, Catherine Hickey4, Sara Shaunfield5, Karen Kaiser5, Jin-Shei Lai5, David Cella6,5,7,8. 1. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. JonathanISilverberg@Gmail.com. 2. Department of Dermatology, Northwestern University Feinberg School of Medicine, Suite 1600, 676 N. St. Clair St., Chicago, IL, 60611, USA. JonathanISilverberg@Gmail.com. 3. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. JonathanISilverberg@Gmail.com. 4. Department of Dermatology, Northwestern University Feinberg School of Medicine, Suite 1600, 676 N. St. Clair St., Chicago, IL, 60611, USA. 5. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 6. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 7. Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 8. Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Abstract
BACKGROUND: Itch is common and often debilitating. Itch is best assessed by self-report, often using patient-reported outcome measures (PROMs). Current PROMs for itch are limited and may not capture its full impact on quality of life (QOL). OBJECTIVE: We sought to develop a comprehensive conceptual model of itch to improve the understanding of itch for clinicians and to serve as a framework for development of efficient and valid PROMs of itch. METHODS: Using mixed methods, including systematic review (n = 491 articles), semi-structured interviews (n = 33 adults with chronic itch with multiple etiologies), and grounded theory using a constant comparative approach, we developed a conceptual model of itch. RESULTS: We found the Wilson and Cleary model to be a reasonable framework for organizing our findings. It includes five primary components: biological and physiological variables, symptom status, functional status, general health perceptions, and QOL. We propose a causal relationship beginning with the biological and physiological driving factors, with direct and indirect impacts of itch and its sequelae, including pain and sleep disturbance. These can impair function, lead to task avoidance, stigma, social life and relationship problems, emotional disturbances, and treatment burden. Together, these sequelae alter one's perceptions of health, QOL, and treatment response. CONCLUSIONS: Our conceptual model demonstrates the profound patient-burden of itch and identifies unmet needs in the evaluation and management of itch.
BACKGROUND:Itch is common and often debilitating. Itch is best assessed by self-report, often using patient-reported outcome measures (PROMs). Current PROMs for itch are limited and may not capture its full impact on quality of life (QOL). OBJECTIVE: We sought to develop a comprehensive conceptual model of itch to improve the understanding of itch for clinicians and to serve as a framework for development of efficient and valid PROMs of itch. METHODS: Using mixed methods, including systematic review (n = 491 articles), semi-structured interviews (n = 33 adults with chronic itch with multiple etiologies), and grounded theory using a constant comparative approach, we developed a conceptual model of itch. RESULTS: We found the Wilson and Cleary model to be a reasonable framework for organizing our findings. It includes five primary components: biological and physiological variables, symptom status, functional status, general health perceptions, and QOL. We propose a causal relationship beginning with the biological and physiological driving factors, with direct and indirect impacts of itch and its sequelae, including pain and sleep disturbance. These can impair function, lead to task avoidance, stigma, social life and relationship problems, emotional disturbances, and treatment burden. Together, these sequelae alter one's perceptions of health, QOL, and treatment response. CONCLUSIONS: Our conceptual model demonstrates the profound patient-burden of itch and identifies unmet needs in the evaluation and management of itch.
Authors: Alex M Rokni; Marissa Ayasse; Adnan Ahmed; Lauren Guggina; Robert W Kantor; Jonathan I Silverberg Journal: Arch Dermatol Res Date: 2022-03-09 Impact factor: 3.017
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Authors: Jennifer M Becker; Henning Holle; Dimitri M L van Ryckeghem; Stefaan Van Damme; Geert Crombez; Dieuwke S Veldhuijzen; Andrea W M Evers; Ralph C A Rippe; Antoinette I M van Laarhoven Journal: PLoS One Date: 2022-09-02 Impact factor: 3.752
Authors: J Puelles; F Fofana; D Rodriguez; J I Silverberg; A Wollenberg; C Dias Barbosa; M Vernon; R Chavda; S Gabriel; C Piketty Journal: Br J Dermatol Date: 2021-11-17 Impact factor: 11.113