RESUMO
Pain contributes substantially to reduced quality of life in individuals living with hidradenitis suppurativa (HS). Although improved understanding of HS pathogenesis and treatment has resulted in improved evidence-based HS management guidelines, comprehensive pain management guidelines have yet to be developed. Few HS-specific data exist to guide pharmacologic analgesia; however, recognizing HS pain as either acute or chronic and predominantly nociceptive (aching and gnawing pain due to tissue damage) versus neuropathic (burning-type pain due to somatosensory nervous system dysfunction) provides a conceptual framework for applying outside pain management practices to HS management. This article incorporates the best available evidence from the HS and pain literature to propose an HS pain algorithm that integrates psychological, pharmacologic, and complementary and alternative treatment modalities.
Assuntos
Algoritmos , Hidradenite Supurativa/complicações , Neuralgia/terapia , Dor Nociceptiva/terapia , Manejo da Dor/métodos , Analgésicos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Antidepressivos Tricíclicos/uso terapêutico , Dor Crônica/etiologia , Dor Crônica/psicologia , Dor Crônica/terapia , Terapia Cognitivo-Comportamental , Terapias Complementares , Depressão/etiologia , Depressão/terapia , Humanos , Neuralgia/etiologia , Neuralgia/psicologia , Neurotransmissores/uso terapêutico , Dor Nociceptiva/etiologia , Dor Nociceptiva/psicologia , Guias de Prática Clínica como AssuntoRESUMO
BACKGROUND: Patient decision aids (PDAs) are tools that facilitate informed shared decision-making between patients and health care providers. To address a previously identified need in treatment decision-making in hidradenitis suppurativa (HS), we developed an HS-PDA. METHODS: Development of the HS-PDA was based on International Patient Decision Aids Standards. Evidence was derived from the North American Clinical Management Guidelines for HS. RESULTS: Content from guidelines was transformed into patient-friendly language and reviewed by three physicians and two patient representatives. Feedback on HS-PDA content, presentation and practicality was obtained from 7 HS patients and 5 physicians. Revisions were made following thematic analysis. All patients felt the content on treatment options contained the right amount of information and 5 found it helpful to see these options contextualized to their values. Each stated they would use the HS-PDA during treatment decision-making. Three and four physicians respectively indicated the content was accurate and language was patient-friendly. LIMITATIONS: Small sample sizes may limit generalizability. CONCLUSION: This HS-PDA was developed in accordance with international standards based on current HS guidelines with input from patients and physicians. It is available online without cost.
