Evaluating Treatment Options in a Patient with Hidradenitis Suppurativa: A Shared Decision Making Approach

A 37-year-old woman presents for follow-up of her hidradenitis suppurativa. She has been under your care for about 2 years now. She was eager to attempt dietary changes. Under your guidance, she eliminated dairy from her diet and started following a Mediterranean diet. This led to a 30% improvement in her disease, including pain, flares, and drainage. Adding spironolactone 150 mg daily helped, but she was still having 2-3 flares per month. After a discussion of her goals and preferences, you engaged in shared decision making and started adalimumab therapy, leading to further improvement. She is still not at her treatment goal. Why is it important to engage in shared decision making for the next treatment decision?