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TOPLINE:

Hidradenitis suppurativa (HS) treatment choices were shaped by past experiences, healthcare provider recommendations, and patient beliefs in the United Kingdom; a new study emphasised the need for personalised care and shared decision-making among patients and healthcare providers.

METHODOLOGY:

• Researchers conducted a nested qualitative study within a prospective cohort study (Treatment of Hidradenitis Suppurativa Evaluation Study [THESEUS]) examining HS treatments in the United Kingdom.
• A total of 35 participants (age, 19-67 years) selected via purposive sampling shared their views, preferences, and experiences relevant to the study over telephone interviews conducted between 2020 and 2021.
• About 71% of the participants were women, and 66% of the participants were White individuals.
• Treatment options included oral doxycycline (200 mg once daily), oral clindamycin and rifampicin (both 300 mg twice daily for 10 weeks), laser treatment, deroofing, and conventional surgery.
• The framework analysis method was used to develop themes from the interview data.

TAKEAWAY:

• Treatment selections were distributed across available options: doxycycline (n = 6), clindamycin and rifampicin (n = 7), laser treatment (n = 9), deroofing (n = 7), and conventional surgery (n = 6).
• Patients had varied past treatment experiences and perceived benefits from each management option, highlighting the need for personalised therapy approaches.
• Medications were reported to pose side effects and adherence challenges, whereas procedures were associated with delays and wound care–related concerns.
• Healthcare professionals' recommendations significantly influenced final treatment decisions, but some patients expressed a preference for increased involvement in decision-making.

IN PRACTICE:

"Patient perceptions of treatments will vary, largely determined by past experiences. Patients' views influence treatment decisions, but so does healthcare professional recommendation. Healthcare professionals need to be careful to elicit the beliefs and preferences of patients and understand the experiences and beliefs driving these preferences to engage in best practice shared decision-making," the authors wrote.

SOURCE:

The study was led by Laura Howells and Paul Leighton, Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom. It was published online on 21 March, 2025, in the British Journal of Dermatology.

LIMITATIONS:

The generalisability to regular clinical practice was limited, as the THESEUS study design may have influenced healthcare conversations. Some participants had not received their treatment by the time of the interview due to COVID-19–related delays, particularly affecting data collection on conventional surgery experiences. Some participants faced challenges recalling details about their initial treatment choice discussions with healthcare providers due to time gaps. The telephone interview format may have influenced the findings.

DISCLOSURES:

The THESEUS study received funding through grants from the National Institute for Health Research Health Technology Assessment. Several authors reported having various ties with various sources. Details are provided in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.