Hyperhidrosis is characterised by uncontrollable excessive sweating. Symptoms can significantly affect quality of life. There is substantial variation in current treatment practice and uncertainty regarding optimal patient management.
To review the clinical effectiveness evidence and establish the expected value of undertaking additional research into effective interventions for primary hyperhidrosis in secondary care.
The assessment included a systematic review and economic model, including value of information analysis. Patients, dermatologists and a specialist nurse (who set up the Hyperhidrosis UK support group) were involved at various stages of the project.
At an end-of-project workshop, the systematic review finding that botulinum toxin injections significantly improved axillary hyperhidrosis symptoms in the short to medium term was supported; there was consensus amongst patients and clinicians that botulinum toxin injections were very effective. The advisors agreed that a trial of botulinum toxin injections versus iontophoresis for palmar hyperhidrosis would be useful. Patients and clinicians were satisfied with the sequence of treatments identified as being cost-effective for axillary hyperhidrosis. All patients considered that the Hyperhidrosis Quality of Life Index (HidroQoL©) was superior to other tools commonly used for assessing quality of life in hyperhidrosis research. Patients considered that the HidroQoL© tool should be the primary outcome in future studies and that measuring the actual amount of sweat produced should only be considered as a secondary outcome.
Patients and clinicians considered the key findings of the systematic review and economic analyses to be appropriate. The advisors were involved in prioritising research recommendations. All patients were in agreement about which quality of life tool they preferred for use in future hyperhidrosis research.
Patient or healthcare consumer involvement:
Capturing the perspectives of patients with hyperhidrosis was an important part of the research. Their involvement in the end-of-project workshop was informative when interpreting the results of the assessment and prioritising research recommendations.