Midgette Bria, Strunk Andrew, Akilov Oleg, Alavi Afsaneh, Ardon Christine, Bechara Falk G, Cohen Arnon D, Cohen Steven, Daveluy Steven, Del Marmol Véronique, Delage Maïa, Esmann Solveig, Fisher Shani, Giamarellos-Bourboulis Evangelos J, Glowaczewska Amelia, Goldfarb Noah, Brant Elena Gonzalez, Grimstad Øystein, Guilbault Sandra, Hamzavi Iltefat, Hughes Rosalind, Ingram John R, Jemec Gregor B E, Ju Qiang, Kappe Naomi, Kirby Brian, Kirby Joslyn S, Lowes Michelle A, Matusiak Lukasz, Micha Stella, Micheletti Robert, Miller Angela P, Moseng Dagfinn, Naik Haley, Nassif Aude, Nikolakis Georgios, Paek So Yeon, Pascual Jose Carlos, Prens Errol, Resnik Barry, Riad Hassan, Sayed Christopher, Smith Saxon D, Soliman Yssra, Szepietowski Jacek C, Tan Jerry, Thorlacius Linnea, Tzellos Thrasyvoulos, van der Zee Hessel H, Villumsen Bente, Wang Lanqi, Zouboulis Christos, Garg Amit
Department of Dermatology, Donald & Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA.
Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, USA.
Br J Dermatol. 2022 Dec;187(6):927-935. doi: 10.1111/bjd.21798. Epub 2022 Sep 3.
Nearly half of patients with hidradenitis suppurativa (HS) report dissatisfaction with their treatment. However, factors related to treatment satisfaction have not been explored.
To measure associations between treatment satisfaction and clinical and treatment-related characteristics among patients with HS.
Treatment satisfaction was evaluated utilizing data from a cross-sectional global survey of patients with HS recruited from 27 institutions, mainly HS referral centres, in 14 different countries from October 2017 to July 2018. The primary outcome was patients' self-reported overall satisfaction with their current treatments for HS, rated on a five-point scale from 'very dissatisfied' to 'very satisfied'.
The final analysis cohort comprised 1418 patients with HS, most of whom were European (55%, 780 of 1418) or North American (38%, 542 of 1418), and female (85%, 1210 of 1418). Overall, 45% (640 of 1418) of participants were either dissatisfied or very dissatisfied with their current medical treatment. In adjusted analysis, patients primarily treated by a dermatologist for HS had 1·99 [95% confidence interval (CI) 1·62-2·44, P < 0·001] times the odds of being satisfied with current treatment than participants not primarily treated by a dermatologist. Treatment with biologics was associated with higher satisfaction [odds ratio (OR) 2·36, 95% CI 1·74-3·19, P < 0·001] relative to treatment with nonbiologic systemic medications. Factors associated with lower treatment satisfaction included smoking (OR 0·78, 95% CI 0·62-0·99; active vs. never), depression (OR 0·69, 95% CI 0·54-0·87), increasing number of comorbidities (OR 0·88 per comorbidity, 95% CI 0·81-0·96) and increasing flare frequency.
There are several factors that appear to positively influence satisfaction with treatment among patients with HS, including treatment by a dermatologist and treatment with a biologic medication. Factors that appear to lower treatment satisfaction include active smoking, depression, accumulation of comorbid conditions and increasing flare frequency. Awareness of these factors may support partnered decision making with the goal of improving treatment outcomes. What is already known about this topic? Nearly half of patients with hidradenitis suppurativa report dissatisfaction with their treatments. What does this study add? Satisfaction with treatment is increased by receiving care from a dermatologist and treatment with biologics. Satisfaction with treatment is decreased by tobacco smoking, accumulation of comorbid conditions including depression, and higher flare frequency. What are the clinical implications of this work? Awareness of the identified factors associated with poor treatment satisfaction may support partnered decision making and improve treatment outcomes.
近半数化脓性汗腺炎（HS）患者表示对其治疗不满意。然而，与治疗满意度相关的因素尚未得到探究。
衡量HS患者的治疗满意度与临床及治疗相关特征之间的关联。
利用2017年10月至2018年7月从14个不同国家的27个机构（主要是HS转诊中心）招募的HS患者的横断面全球调查数据评估治疗满意度。主要结局是患者对其目前HS治疗的自我报告总体满意度，采用从“非常不满意”到“非常满意”的五点量表进行评分。
最终分析队列包括1418例HS患者，其中大多数是欧洲人（55%，1418例中的780例）或北美人（38%，1418例中的542例），且为女性（85%，1418例中的1210例）。总体而言，45%（1418例中的640例）的参与者对其目前的药物治疗不满意或非常不满意。在调整分析中，主要由皮肤科医生治疗HS的患者对当前治疗满意的几率是未主要由皮肤科医生治疗的参与者的1.99倍[95%置信区间（CI）1.62 - 2.44，P < 0.001]。与使用非生物系统性药物治疗相比，使用生物制剂治疗与更高的满意度相关[优势比（OR）2.36，95% CI 1.74 - 3.19，P < 0.001]。与较低治疗满意度相关的因素包括吸烟（OR 0.78，95% CI 0.62 - 0.99；当前吸烟者与从不吸烟者）、抑郁（OR 0.69，95% CI 0.54 - 0.87）、合并症数量增加（每增加一种合并症OR 0.88，95% CI 0.81 - 0.96）以及发作频率增加。
有几个因素似乎对HS患者的治疗满意度有积极影响，包括由皮肤科医生治疗和使用生物制剂治疗。似乎会降低治疗满意度的因素包括当前吸烟、抑郁、合并症的累积以及发作频率增加。了解这些因素可能有助于以改善治疗结果为目标的共同决策。关于该主题已知的信息有哪些？近半数化脓性汗腺炎患者报告对其治疗不满意。本研究增加了什么内容？由皮肤科医生提供护理和使用生物制剂治疗可提高治疗满意度。吸烟、包括抑郁在内的合并症累积以及更高的发作频率会降低治疗满意度。这项工作的临床意义是什么？了解与治疗满意度低相关的已确定因素可能有助于共同决策并改善治疗结果。
