Patients’ experiences of primary healthcare and dermatology provision for alopecia (preprint)

Abstract

Aim: In this study, we aim to understand patients’ perceptions of current primary healthcare and dermatology provision by patients with alopecia in the United Kingdom (UK). Our related aim is to investigate how care provision and patients’ overall patient journey might be improved in the UK, and how these lessons may apply internationally. Background: Alopecia describes a group of dermatological conditions characterised by hair loss, which are either non-scarring or scarring in nature, and range from bald patches to complete body hair loss, to general thinning. In the UK, the General Practitioner (GP) situated in Primary Health Care is typically the first point of contact when hair loss occurs, and some patients are referred for specialist dermatology consultation. However, little is known about how individuals with alopecia in the UK experience the care provided by the National Health Service. Methods: An online mixed methods survey was distributed by Alopecia UK to UK-based individuals with alopecia. Open-ended text responses were analysed using qualitative content analysis. Quantitative data were analysed using descriptive analyses and dependent measures t tests. Findings: Participants reported neutral-to-partial dissatisfaction with their GP appointments, with greater satisfaction in their most recent compared to their first appointment. Content analysis of participants’ textual responses highlighted positive experiences with GPs and dermatologists as well as areas for improvement. A consistent finding throughout the survey was participants’ desire for a greater degree of support and understanding about the psychological impact of alopecia. Results highlight the importance of being empathic and caring as healthcare professionals for patients with alopecia, the need for training for GPs on alopecia, as well as a simplified and joined up pathway between primary and secondary healthcare for patients.