Factors influencing alopecia areata treatment decisions: A qualitative assessment.

BACKGROUND

Alopecia areata (AA) is a disease of hair loss in which patients may benefit from comprehensive understanding of AA's disease process and therapeutic options during treatment decision-making.

OBJECTIVE

Determine factors influencing patients' AA treatment decision-making.

METHODS

Qualitative interviews were conducted using semi-structured interview guides. Interviews were coded using inductive thematic analysis.

RESULTS

Twenty-one participants with AA were interviewed. Coding interrater reliability was κ = 0.87-0.91, indicating strong-almost perfect agreement. Participants faced multiple barriers, including lack of access to health care ( = 10, 47.6%) and lack of transparency about their condition and treatment options ( = 9, 42.9%). Information about AA was sought from primarily the internet ( = 15, 71.4%) and physician recommendation ( = 15, 71.4%). When choosing AA treatments, patients often considered treatment efficacy ( = 21, 100%), safety ( = 21, 100%), and convenience of use ( = 20, 95.2%).

LIMITATIONS

Referral and regional biases may be present and limit generalizability.

CONCLUSIONS

Patients with AA face various challenges including medical uncertainty and lack of information. Patients need trustworthy and accessible sources of information regarding their treatment that also take into consideration their preferences and values.