The following is a summary of “Factors Affecting Treatment Selection Among Patients With Hidradenitis Suppurativa,” published in the January 2024 issue of Dermatology by Salame, et al.
Despite the US Food and Drug Administration’s approval of adalimumab for treating hidradenitis suppurativa (HS), there remained a notable discrepancy between evidence-based guidelines and clinical practice, resulting in low prescription rates. Understanding the factors influencing the medical decision-making process among these patients, particularly regarding biologic therapies, could reveal opportunities for enhancing patient-physician communication and improving HS disease management. For a study, researchers sought to explore the factors influencing the medical decision-making process among patients with HS, focusing on biologic therapies.
Open-ended semi-structured interviews were conducted with English-speaking adults diagnosed with HS (aged ≥18 years) recruited from two dermatology clinics affiliated with Emory University School of Medicine in Atlanta, Georgia. All participants reported an average 7-day pain score of 1 or higher on a 0- to 10-point numeric rating scale. Surveys were administered between November 2019 and March 2020, with data analyzed from December 2021 to August 2022. Data collection continued until thematic saturation was achieved, comprising 21 interviews.
The analysis included 21 participants (median [IQR] age, 38.5 [27.9-43.4] years; 16 females [76%]). Nearly all participants (96%) had Hurley stage II or III disease, and 15 (71%) had previously used adalimumab. Factors influencing participants’ decisions to initiate new HS treatments included their threshold for suffering, perceptions of treatment risk, treatment fatigue, understanding of the disease, and sources of information (such as dermatologists, the internet, advertisements, and friends and loved ones).
The qualitative study suggested that addressing misconceptions about treatment risk, bridging gaps in disease knowledge, and highlighting the importance of early treatment to prevent scarring and disease progression could empower patients with HS to participate in treatment decision-making and actively consider new therapies.
Reference: jamanetwork.com/journals/jamadermatology/fullarticle/2813822