Optimizing hidradenitis suppurativa clinic visits: Patient perspectives

Shih, Terri; De, Devea R.; Brooks, Brindley; Fixsen, Denise; Shi, Vivian Y.; Hsiao, Jennifer L.

doi:10.1097/jw9.0000000000000040

Cited by 5 publications

(5 citation statements)

References 4 publications

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“…Regardless of impact on HS disease activity, counseling on lifestyle modifications for diet, exercise, and smoking cessation should be performed for the overall health of HS patients. Of note, addressing lifestyle changes after the first establishing rapport with patients is helpful [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Low Rates of Psychosocial Screening and Lifestyle Counseling in Hidradenitis Suppurativa Patients in the USA

Shih

Rick

et al. 2023

Skin Appendage Disord

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Introduction: Although hidradenitis suppurativa (HS) is associated with psychosocial comorbidities such as depression as well as modifiable comorbidities such as obesity, rates of psychosocial screening and lifestyle counseling in the USA have not been characterized. Methods: This cross-sectional study utilized publicly available data from the National Ambulatory Medical Care Survey (NAMCS) between 2008 and 2018 to identify visits with a diagnosis of HS (ICD-9 code 705.83, ICD-10 code L73.2). T tests and multivariate logistic regressions analyzed trends in rates of screening and counseling while controlling for race, sex, and age. Survey weights are applied to each visit to represent a national sample. Results: Depression screening was completed in only 2% of reported visits. No visits reported screening for alcohol misuse, substance abuse, or domestic violence. There were low rates of counseling for weight reduction (7.8%), diet and nutrition (3.3%), exercise (2.4%), smoking (1.0%), and substance abuse (0.7%). Black patients and individuals with public health insurance received less screening and counseling overall. Conclusion: Rates of psychosocial screening and counseling on lifestyle modifications are low in ambulatory clinic visits for HS patients, and there are disparities based on race and insurance status. Implementing strategies to incorporate routine psychosocial screening and lifestyle counseling into visits may improve HS patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Low Rates of Psychosocial Screening and Lifestyle Counseling in Hidradenitis Suppurativa Patients in the USA

Shih

Rick

et al. 2023

Skin Appendage Disord

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“…Physician communication strategies should be examined for opportunities to help lower this barrier 4 . For example, patients may prefer that sensitive topics such as weight loss and sexual health be addressed at a later visit, after rapport has been developed 5 . Further, all staff, starting from the front‐desk and extending to the back office, should be trained to facilitate patient‐centred and non‐judgemental interactions, especially given the embarrassment patients with HS have reported feeling regarding their skin condition.…”

Section: Discussionmentioning

confidence: 99%

No‐shows to hidradenitis suppurativa clinic visits: Patient perspectives

Fragoso,

Masson,

Shih

et al. 2023

Skin Health and Disease

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BackgroundHidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin condition that typically requires consistent care. Contributory factors to why patients with HS miss their clinic appointments have not been investigated.ObjectivesThis article seeks to characterise reasons that HS patients do not keep their appointments and identify strategies to minimise no‐show rates and improve delivery of care to HS patients.MethodsAn anonymous survey was distributed to online HS support groups.ResultsOf the 254 respondents, 18.9% reported ever missing an appointment for HS. Common reasons for missing an appointment include: patient was experiencing an HS flare (72.9%), prior poor experience with a healthcare provider (54.2%) or healthcare staff member (37.5%), embarrassment of condition (41.7%), and distrust that the appointment would help with management of HS (39.6%). Respondents who were non‐White, who were disabled, or who had lower socioeconomic status were more likely to have missed an appointment (p < 0.05).ConclusionsThis study highlights areas where dermatologists may help improve appointment attendance, including encouraging patients to seek care during flares and striving to optimise the patient experience.

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“…By engaging in open dialogue with patients, particularly with minority patients, about the impact of HS on reproductive health, providers may be able to mitigate potential barriers to intimate relationships and family planning. Importantly, an earlier HS survey study found that topic of sexual health is best discussed with great sensitivity, only after establishing rapport [ 17 ]. Since 67.3% of respondents expressed concerns about the effects of at least one HS treatment on fertility, addressing these potential apprehensions may also increase HS medication adherence.…”

Section: Discussionmentioning

confidence: 99%

Patient Perspectives on Hidradenitis Suppurativa and Infertility: A Survey Study

Masson,

Shih,

Park

et al. 2023

Dermatology

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Background: Hidradenitis suppurativa (HS) is an inflammatory skin condition which predominantly affects women of childbearing age in the USA. There is a lack of research on the association between HS and fertility. Objectives: The aim of this study was to understand the perspectives of females with HS regarding the impact of their disease on reproductive health, the impact of fertility treatments on HS, and the impact of HS treatments on fertility. Methods: An anonymous, online survey was disseminated through HS support groups from June to July 2022. Respondents aged 18–50 who were assigned female sex at birth were eligible for participation. Comparative statistics were performed using t tests/χ2 tests to assess associations between respondents’ demographics and survey responses. Results: Among the 312 respondents (80.8% White, mean age 35.7 ± 7.4 [range 18–50]), two-thirds of respondents (66.6%, 207/311) had been pregnant before and 79.5% (248/312) had ever tried to conceive. 41.5% (103/248) had unsuccessfully tried to conceive for 12 months or more. Of the 59 respondents who had never attempted to conceive, 39% reported that HS had impacted this decision. Amongst respondents who experienced fertility challenges but did not pursue fertility treatments, top barriers to fertility treatments include concerns about financial support/insurance coverage (47.5%, 29/61) and fertility treatments worsening HS (21.3%, 13/61). Most respondents who used fertility treatments reported either no change (73.7%, 28/38 or 77.8%, 14/18) or improvement (15.8%, 6/38 or 11.1%, 2/18) in their HS symptoms with oral or injectable medications. Respondents were most concerned about the effects of oral antibiotics (44.9%, 140/312), followed by hormonal medications (38.8%, 121/312) and biologics (35.9%, 112/312) on fertility. Conclusion: Females with HS reported high rates of infertility compared to the general population. The majority reported no change in HS symptoms with fertility treatments, and clinicians can use this finding to help counsel patients during family planning discussions. Further research in the field of HS and fertility is needed.

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Optimizing hidradenitis suppurativa clinic visits: Patient perspectives

Cited by 5 publications

References 4 publications

Low Rates of Psychosocial Screening and Lifestyle Counseling in Hidradenitis Suppurativa Patients in the USA

Low Rates of Psychosocial Screening and Lifestyle Counseling in Hidradenitis Suppurativa Patients in the USA

No‐shows to hidradenitis suppurativa clinic visits: Patient perspectives

Patient Perspectives on Hidradenitis Suppurativa and Infertility: A Survey Study

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