Drake Lara, Han Jane, Reyes-Hadsall Sophia, Mostaghimi Arash, Huang Kathie
Tufts University School of Medicine, Boston, Massachusetts, USA.
Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Skin Appendage Disord. 2023 Mar;9(2):99-103. doi: 10.1159/000527251. Epub 2022 Dec 15.
Alopecia areata (AA) is an autoimmune condition that results in nonscarring hair loss. There is currently only one Food and Drug Administration (FDA)-approved treatment for AA; as a result, a wide range of treatments are commonly administered. This study aimed to determine how patients with AA prioritize treatment characteristics when choosing a therapy.
A cross-sectional national survey was distributed using the National Alopecia Areata Foundation's (NAAF) email list. This study was approved by the Mass General Brigham Institutional Review Board. Participants were asked to rank the importance of five treatment domains.
Of the 1,074 completed surveys (completion rate 77.4%), most respondents were female (85.4%) and white (77.8%) with an average age of 49.3 ± 15.4 years. Respondents had AA for an average of 17.7 ± 15.4 years, with 90.0% experiencing current active hair loss. 95.6% of respondents considered the treatment's ability to achieve hair regrowth as important, 93.9% listed the availability of information about the treatment (e.g., via doctor or online) as important, 89.1% ranked the treatment side effects as important, 75.7% the cost, and 68.0% the convenience of use. A sub-analysis was performed examining responses between respondents who identify as white versus nonwhite, which showed that while the order of importance was the same between groups, a significantly larger proportion of nonwhite respondents attributed higher importance to cost (white: 73.8%, nonwhite: 82.4%; = 0.006) and convenience (white: 65.3%, nonwhite: 77.3%; < 0.001) than their white counterparts.
DISCUSSION/CONCLUSION: These findings identify key domains that can serve as a starting point in shared decision-making between patients and physicians. This knowledge can streamline dermatologist delivery of key information and highlight areas of improvement for future therapeutics. Limitations include the nonrandomized NAAF population with most participants being white females. Future studies should confirm these findings in other patient populations.
斑秃（AA）是一种自身免疫性疾病，会导致非瘢痕性脱发。目前美国食品药品监督管理局（FDA）仅批准了一种用于治疗斑秃的药物；因此，人们通常会采用多种治疗方法。本研究旨在确定斑秃患者在选择治疗方法时如何对治疗特征进行优先级排序。
使用国家斑秃基金会（NAAF）的电子邮件列表进行了一项全国性横断面调查。本研究获得了麻省总医院布莱根分院机构审查委员会的批准。参与者被要求对五个治疗领域的重要性进行排序。
在1074份完成的调查问卷中（完成率77.4%），大多数受访者为女性（85.4%），白人（77.8%），平均年龄为49.3±15.4岁。受访者患斑秃的平均时间为17.7±15.4年，其中90.0%的人目前正在经历脱发。95.6%的受访者认为治疗方法促进头发生长的能力很重要，93.9%的人认为获得有关治疗方法的信息（例如通过医生或网络）很重要，89.1%的人将治疗副作用列为重要因素，75.7%的人认为成本重要，68.0%的人认为使用便利性重要。对自认为是白人或非白人的受访者的回答进行了亚组分析，结果显示，虽然两组之间重要性的排序相同，但与白人受访者相比，非白人受访者中认为成本（白人：73.8%，非白人：82.4%；P = 0.006）和便利性（白人：65.3%，非白人：77.3%；P < 0.001）更重要的比例明显更高。
讨论/结论：这些发现确定了关键领域，可作为患者与医生共同决策的起点。这些知识可以简化皮肤科医生提供关键信息的过程，并突出未来治疗方法需要改进的领域。局限性包括NAAF的非随机人群，且大多数参与者为白人女性。未来的研究应在其他患者群体中证实这些发现。
