Pruritus (the medical term for itching) can be chronic and resistant to treatment in some cases, according to background information in the article. When this happens, a patient can experience depression, distress and problems sleeping. But although the condition shares similarities with pain, "research relating to this symptom has not been as well established as in other chronic conditions such as pain," write the authors. They sought to use health utility scores, which determine satisfaction levels in health states, to compare pain and pruritus.
Seema P. Kini, M.D., M.S.C.R., from Emory University School of Medicine, Atlanta, and colleagues recruited 138 patients with chronic pain and 73 patients with chronic pruritus. Participants filled out questionnaires and took part in interviews to evaluate the effect that these symptoms had on QoL. The measures generated utility scores, which chart the burden of the condition on a scale of 0 (death) to 1 (perfect health). The utility score represented how much of their life expectancy participants would be willing to forgo in order to live without the pain or pruritus.
Demographically the groups were similar, although patients with pain were more likely to describe this symptom as severe (36 percent vs. 28 percent with pruritus). Participants with pruritus had a mean (average) utility score of 0.87, whereas participants with pain had a mean utility score of 0.77. After other variables were analyzed, being unmarried and having severe symptoms were significant predictors of the symptom utility score.
The authors point out that their data suggest chronic pruritus is taxing and detrimental to QoL, prompting patients to hypothetically trade 13 percent of their life expectancy to live without this symptom. They address the role of single marital status by pointing to research which has associated relationships and social support with reduced burden of illness. Further research of the effect of pruritus on QoL is needed, they state. Finally, the researchers say, "Our study provides a model to compare common debilitating symptoms that are best self-reported and have very few objective findings."