Addressing misconceptions about treatment risk to empower better decision-making is important.

Researchers seeking to address the gap between evidence-based guidelines and clinical practice in the treatment of hidradenitis suppurativa (HS) have identified several factors influencing patient decision-making.

The open-ended, two-center study, conducted through open-ended interviews with adults aged 18 years and older with HS, looked at factors influencing the medical decision-making process, particularly concerning biologic therapies. Prescription rates of adalimumab are low, despite the U.S. Food and Drug Administration's approval of adalimumab for HS, highlighting a need for improved patient-physician communication and disease control. Study participants, totaling 21 individuals (median age of 38.5 years), were recruited based on an average 7-day pain score of 1 or higher on a numeric rating scale.

According to the reported results, almost all participants (96%) had Hurley stage II or III disease, and 71% had a history of adalimumab use. The researchers also identified suffering threshold, perceptions of treatment risk, treatment fatigue, disease understanding, and sources of information (such as dermatologists, the internet, advertisements, and input from friends and loved ones) as factors affecting the decision to initiate new treatments for HS.

"Results of this qualitative study suggest that mitigating misconceptions about treatment risk, identifying gaps in disease knowledge, and emphasizing early treatment to prevent scarring and disease progression may empower patients with HS to engage in treatment planning and to try new therapies," the authors wrote. 

Source: Salame N, Sow YN, Siira MR, et al. Factors affecting treatment selection among patients with hidradenitis suppurativa. JAMA Dermatology. Published online January 10, 2024. doi:https://doi.org/10.1001/jamadermatol.2023.5425