Rationale of Patient-Initiated Loss to Follow Up in Hidradenitis Suppurativa Patients

Abstract

Introduction: Hidradenitis Suppurativa (HS) is a chronic inflammatory skin condition with a predilection for African American and female patients. HS consists of recurrent abscesses and sinus tracts in intertriginous areas. This condition has debilitating medical and psychosocial consequences, with treatment of severe cases remaining difficult. This may lead to patient frustration and lack of follow-up. This study aims to explore the rationale of HS patient-initiated loss to follow-up. Methods: We identified 72 patients at a single center with dermatologist-diagnosed HS seen within the last 12 months (06/30/2021-06/30/2022). Of those 72 patients, 35 were determined to be severe. Of those 35 patients, 11 were not seen within the last 6 months and thus lost to follow-up. These individuals were polled to explore the rationalization of discontinued treatment. Results: Of the 11 patients with severe HS that were lost to follow up, 4 did not respond after three attempts at contact. Of the remaining 7 patients, 3 (27. 27%) reported discontinued care due to scheduling conflicts, 1 (9.09%) had improvement of symptoms, 1 (9.09%) lost medical coverage, 1 (9.09%) cost, and 1 (9.09%) discontinued care due to a competing comorbidity. Discussion: This study determined that of the 7 patients with severe HS that were reached, the largest contributor to patient-initiated loss to follow-up were scheduling conflicts. Thus, the results reported in this study indicate a need for further research into the proactive dismantling of barriers preventing patients from receiving adequate and effective care.