Impact of Chronic Urticaria on Major Life-Changing Decisions: Greater Burden in Social, Physical, and Job/Career Domains

Abstract

Chronic urticaria (CU) is a common condition associated with a substantial burden on patients and society, characterized by persistent symptoms and reduced sense of life control. Although existing patient‐reported outcome measures (PROMs) assess disease activity and quality of life, they largely reflect the current disease state, and evidence on CU's long‐term impact on major life‐changing decisions (MLCDs) remains scarce. Objectives To evaluate CU's long‐term impact on MLCDs and assess the validity and reliability of the Turkish MLCDP. Methods The MLCDP is a 32‐item questionnaire assessing the impact of chronic diseases on MLCDs across five domains. A linguistically validated Turkish version was developed using a forward–backward translation process. In this multicentre cross‐sectional study, 111 Turkish‐speaking CU patients (≥ 16 years) completed the MLCDP and other PROMs during follow‐up visits. Results CU affected at least one MLCD in 79.3%, impacting social (77, 69.4%), physical (63, 56.8%), job/career (41, 36.9%), family/relationships (23, 20.7%) and education (9, 8.1%) domains. The most commonly affected decisions of each domain were changing eating habits (67, 60.4%), not taking part in any sport activities (35, 31.5%), working flexible hours (26, 23.4%), not having a sexual relationship (16, 14.4%) and studying near home (6, 5.4%), respectively. Patients with disease onset ≤ 45 years had higher rates of at least one affected MLCD than those > 45 years (74, 82.2% vs. 10, 58.8%, p < 0.05). Similarly, patients with an emergency referral in the last year (30, 93.8% vs. 58, 74.4%) and those who missed school/workdays in the last year (24, 100% vs. 64, 73.6%) showed higher rates of at least one affected MLCD compared with those without (all p < 0.05). Limitations The small sample size, single‐cohort cross‐sectional design, lack of controls, self‐reported measures, inclusion of patients with short disease duration and unassessed potential confounders such as comorbidities, medications and personality traits. Conclusions CU has a long‐term impact on major life‐changing decisions, especially in social, physical, and job/career decisions of the patients. Younger patients and those with severe disease are particularly affected.