Understanding What Matters to Patients with Chronic Urticaria
Chronic urticaria, characterized by persistent hives, itching, and swelling, can profoundly disrupt daily life. A recent systematic review of 18 studies involving more than 28,000 participants highlights what patients and caregivers value most when choosing treatments. While efficacy is essential, how a treatment aligns with patients’ preferences can determine adherence and overall quality of life.
Rapid Relief and Long-Term Control Take Priority
The review consistently found that patients seek fast symptom relief, ideally within two weeks, coupled with durable control of hives, itching, and swelling. When two treatments show similar effectiveness, people tend to favor options that act quickly and maintain control over time. Rapid relief not only reduces discomfort but also helps restore normal daily activities, work performance, and social participation.
In addition to speed, patients weigh the ability to sustain symptom control over the long term. Treatments that provide ongoing suppression of hive activity and itch contribute to better overall well-being and fewer flare-ups, underscoring the value of therapies with durable benefits.
Safety and Tolerability Shape Decisions
Safety considerations are integral to treatment choice. Participants preferred options with milder adverse effects and a lower risk profile. For example, they favored therapies with minor injection-site reactions or transient side effects over those linked to more serious risks, such as potential kidney impairment. The balance between rapid relief and cumulative safety over time emerged as a key factor guiding decisions, particularly for people using these therapies for extended periods.
Convenience, Autonomy, and Daily Life
Beyond efficacy, the mode of administration and convenience significantly influence preferences. Oral and topical medications were generally favored over injections or infusions due to ease of use and reduced disruption to daily routines. This preference reflects a broader desire for autonomy and minimal life interference, which is especially meaningful for patients and caregivers managing chronic disease long-term.
Implications for Clinical Practice
These findings urge clinicians to integrate patient values into shared decision-making. When clinicians discuss treatment options, they should explicitly address: (1) how quickly a therapy is expected to work, (2) how well it sustains control over time, (3) the safety and tolerability profile, and (4) the practicality of taking the medication in daily life. Emphasizing speed, durability, safety, and ease of use can enhance patient satisfaction, improve adherence, and ultimately improve health-related quality of life for people living with chronic urticaria.
Practical Takeaways for Patients and Caregivers
Patients should feel empowered to ask about expected onset of action, the likelihood of sustained control, common side effects, and how a treatment fits into daily routines. Caregivers can help evaluate the burden of administration and monitoring requirements. By centering conversations on rapid relief, safety, and convenience, treatment plans can be more closely aligned with what matters most to those affected by chronic urticaria.
Reference
Chu X et al. Patient values and preferences in chronic urticaria treatment: a systematic review. JAMA Dermatol. 2025;DOI:10.1001/jamadermatol.2025.3663.
