A qualitative interview study exploring patient views and experiences of treatment for hidradenitis suppurativa in the UK.

BACKGROUND: Hidradenitis suppurativa (HS) is a long-term skin condition where evidence for management after first line treatment fails is limited, and practice varies across the UK. Both medical and surgical treatment options are potential avenues for treatment. Furthermore, patient perspectives on HS treatments have received little attention in research to date. AIM: To explore patients' views and experiences of treatment for HS to inform clinical care. METHODS: A nested qualitative study within a prospective cohort study. Interviews with 35 participants were completed by telephone. Purposive sampling was undertaken. Framework analysis was used to develop themes. RESULTS: Views on treatments: Past experiences and knowledge informed patient beliefs and whether an individual felt a treatment option was appropriate or a good 'fit' for them at a specific moment in time. Healthcare professional recommendations can be influential on both patient's views and which treatment option they ultimately receive. Experiences of treatments: There were positive experiences across all treatment types used within the study. Negative experiences included side effects of medications, lack of efficacy, delays to procedures, and burden of wound care. However, even when personal experiences were not wholly positive for an individual, participants often believed the same treatment may potentially help others with HS, due to the importance placed on personalisation of treatment. CONCLUSIONS: This paper has implications for how healthcare professionals discuss treatment options with people with HS. A 'one size fits all' approach is inappropriate, and shared decision making that elicits patient beliefs and preferences is crucial.