Abstract
BackgroundIn acne, several studies report a poor adherence to treatments. We evaluate, in a real-life setting conditions, the impact of compliance to physician’s instructions, recommendations and adherence to the treatments on clinical outcome in patients with mild to moderate acne in an observational, non-interventional prospective study carried out in 72 Dermatologic Services in Spain (ACTUO Trial).MethodsSix-hundred-forty-three subjects were enrolled and 566 patients (88 %) completed the 3 study visits. Study aimed to evaluate the impact of adherence (assessed with ECOB scale) on clinical outcome, as well as how the use of specific adjuvant treatments (facial cleansing, emollient, moisturizing and lenitive specific topical products) influences treatment’s adherence and acne severity (0–5 points score). Recommendation of specific adjuvant skin barrier repair products was made in 85.2 %.ResultsOverall, clinical improvement was observed throughout follow-up visits with an increased proportion of patients who reported reductions of ≥50 % on the total number of lesions (2 months: 25.2 %; 3 months: 57.6 %) and reductions of severity scores (2.5, 2.0 and 1.3 at 1, 2 and 3 months after treatment, respectively). Adherence to treatment was associated with a significant reduction on severity grading, a lower number of lesions and a higher proportion of patients with ≥50 % improvement.ConclusionsGood adherence to medication plus adherence to adjuvants was significantly associated with a higher clinical improvement unlike those that despite adherence with medication had a low adherence to adjuvants. A good adherence to adjuvant treatment was associated with improved adherence and better treatment outcomes in mild to moderate acne patients. (ISRCTN Registry: ISRCTN14257026).
Highlights
IntroductionSeveral studies report a poor adherence to treatments. We evaluate, in a real-life setting conditions, the impact of compliance to physician’s instructions, recommendations and adherence to the treatments on clinical outcome in patients with mild to moderate acne in an observational, non-interventional prospective study carried out in 72 Dermatologic Services in Spain (ACTUO Trial)
In acne, several studies report a poor adherence to treatments
Specific systemic and topical acne treatments are very often associated with local side effect such as dry, burning and itching sensations [7] poor tolerability further worsens compliance [11].,Based on the evidence and clinical experience obtained with topical treatments and their possible irritant effects [12], adjuvant skin barrier repair therapies such as specific emulsion and detergent products, hydrating and emollients are often prescribed in order to reduce these side effects, all in search of improving adherence to therapeutic strategies [13, 14]
Summary
Several studies report a poor adherence to treatments. We evaluate, in a real-life setting conditions, the impact of compliance to physician’s instructions, recommendations and adherence to the treatments on clinical outcome in patients with mild to moderate acne in an observational, non-interventional prospective study carried out in 72 Dermatologic Services in Spain (ACTUO Trial). Specific systemic and topical acne treatments are very often associated with local side effect such as dry, burning and itching sensations [7] poor tolerability further worsens compliance [11].,Based on the evidence and clinical experience obtained with topical treatments and their possible irritant effects [12], adjuvant skin barrier repair therapies such as specific emulsion and detergent products, hydrating and emollients are often prescribed in order to reduce these side effects, all in search of improving adherence to therapeutic strategies [13, 14] Other factors such as a good and efficient physician-patient relationship are crucial for improving adherence to therapeutic strategy [15] since this interaction includes specific roles and motivations [16] that might be essential to the healing of many patients, so for patients with chronic disease or disease having a negative impact on quality of life and self-esteem such as acne [17]. The participating physicians of the ACTUO trial were practicing experienced Spanish dermatologists working in hospital outpatient dermatology services
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