No‐shows to hidradenitis suppurativa clinic visits: Patient perspectives

December 10, 2023

This plain-language research summary was generated by AI, courtesy of HS Simplified.

AI Generated Content Verified By: Natalie Fragoso, M.D. | Dartmouth Health

No‐shows to hidradenitis suppurativa clinic visits: Patient perspectives

In 2023, a study explored why patients with hidradenitis suppurativa (HS)—a chronic inflammatory skin condition—missed doctor visits. Key reasons included HS flares, negative medical experiences in the past, and embarrassment from their skin condition. Improved patient-doctor communication and flexible visits like telehealth were suggested to reduce these missed visits, enhancing care delivery.

Why Do People With Hidradenitis Suppurativa Miss Doctor Visits?

Hidradenitis suppurativa (HS) is a long-lasting skin disease that causes painful lumps, usually in areas where skin rubs together, like the armpits or groin. It can really hurt a person’s quality of life. Sometimes, people with HS miss their doctor appointments, which can make managing their condition harder. The researchers wanted to find out why patients with HS miss visits, so doctors can help them get better care.

How Did They Study This?

The experimenters sent out an anonymous survey to adults in online HS support groups. Over two months, anyone ages 18 and older with HS could answer. They asked about things like age, race, money, education, and reasons for missing appointments. They also looked at how serious the person’s HS was by asking about their Hurley stage, which is a way to measure how bad HS is.

Main Reasons for Missing Appointments

Out of 254 people who answered, about 1 in 5 had missed a doctor visit for their HS. The top reasons were:

• HS flare (when the skin problem suddenly gets worse and more painful)
• Having a bad experience with a doctor or medical staff member in the past
• Feeling embarrassed about their skin
• Thinking the visit wouldn’t help

Money and getting to the clinic also made it hard for some people to go. Very few said they just forgot their appointment.

Who Was More Likely to Miss Visits?

The researchers found that people who had a disability, had lower income, or were non-White were more likely to miss appointments. Gender, education, type of insurance, and how long they had HS did not make a difference.

How Can Doctors Help?

Patients said they would be more likely to keep appointments if:

• Schedules were more flexible
• They could cancel online
• Telehealth (video) visits were offered
• They got reminders by text or email before the visit
• They got help with transportation

Why Does This Matter?

Missing appointments can lead to worse flares and missed chances for treatment, making HS harder to control. Some patients didn’t go to appointments because they were having a bad flare, but skipping visits can lead to even more problems later. It’s important for doctors to encourage patients to come in—even during a flare—and to offer advice on how to manage symptoms at home.

Making Care Better

The study found that kindness and understanding from doctors and staff made a big difference. Many patients had skipped visits after a negative experience or because they felt embarrassed about their skin. Simple changes, like listening more and being careful with sensitive topics, could help.

Limitations of the Study

The researchers pointed out some problems with their study. Most people who answered were White and female, so the results might not match all HS patients. Also, people in online support groups might be more likely to keep appointments than people who do not belong to an online support group, which could make the results look better.

Conclusion

In summary, people with HS often miss doctor visits because of painful flares, bad past experiences, embarrassment, and money or travel problems. More flexible scheduling, telehealth, and better doctor-patient relationships could help. Doctors should encourage patients to come even during a flare and treat all patients with respect and understanding.

Author(s)

Natalie M. Fragoso, Rahul Masson, Terri Shih, Tiffany Mayo, Ginette Okoye, Vivian Y. Shi, Jennifer L. Hsiao

Read Original Paper

https://academic.oup.com/skinhd/article/4/2/ski2.322/7736672