Literature Collection

BACKGROUND: Hidradenitis suppurativa (HS) is a painful, chronic, inflammatory skin condition affecting the skin folds. It is frequently misdiagnosed, leading to delays in care and the progression of the disease to permanent scarring. AIM: To understand the level of knowledge and confidence of HCPs in primary care managing patients with HS. To establish their ability to recognise the early signs of HS, awareness of associated comorbidities, and recognition of treatment options available in primary care. DESIGN & SETTING: A survey was distributed to HCPs working in primary care METHOD: The survey was disseminated via weekly GP bulletins distributed by local integrated care boards, the primary care dermatology society mailing lists and at professional events. RESULTS: Of 187 respondents, most (93%) did not have a specialist role in dermatology or a postgraduate qualification in dermatology (69%), 36 (20%) were not doctors, and there was a good geographical spread over the UK. Of the respondents, 74% felt confident diagnosing HS, but only 39% were confident in managing the pain associated with the disease. Perceived confidence did not correlate with understanding the importance of early referral to secondary care where multiple skin sites were affected. CONCLUSION: Further education in diagnosing and managing HS in primary care is needed. Future research could focus on developing a tool to support the diagnosis of HS in primary care and a clear, primary care-focused management guideline for identified patients.

INTRODUCTION: Child Psychiatry Access Programs (CPAPs), like Maryland Behavioral Health Integration in Pediatric Primary Care (BHIPP), help address the behavioral health treatment gap. This study examined demographic and clinical characteristics of children aged 0-5 years for whom primary care providers (PCPs) and/or families sought BHIPP services, and recommendations provided by BHIPP. METHOD: Descriptive and chi-square statistics were used to examine BHIPP services received, patient demographics, presenting problems, diagnostic impressions, clinical severity, treatments the patient was receiving before BHIPP contact, and BHIPP's treatment recommendations and referrals from 1,671 unique patient-specific contacts between October 2012 and June 2023. RESULTS: Older children in this sample presented to BHIPP as more complex and severe. The most common treatment recommendation and referral made by BHIPP were referral to a community behavioral health provider and outpatient psychotherapy, respectively. DISCUSSION: This study highlights the important role of PCPs in addressing early childhood behavioral health concerns and CPAPs' role in supporting PCPs and improving access to early childhood behavioral health care.