Four Questions Assess Acne Patient Quality of Life

ORLANDO – A four-question survey can provide as much information about the psychosocial impact of acne treatment on patients as do longer, more cumbersome surveys.

Dr. Peter Saitta and colleagues developed the Acne-Q₄ survey and reported that it compared favorably with the results of the conventional, 19-item Acne-QoL survey that is commonly used in research.

Dr. Peter Saitta

Because of its brevity, Acne-Q₄ has the potential to be used by dermatologists in private practice and to give them a "total score that can be used to assess a patient’s improvement with a treatment course," said Dr. Saitta, chief resident at the department of dermatology at Michigan State University/Oakwood Healthcare System in Trenton.

"The survey can be used in the waiting room and the total score can be added up by the nurse," he said in an interview.

The impact of acne vulgaris can be profound on a patient’s health-related quality of life, similar to what patients with chronic diseases like asthma, arthritis, and diabetes report.

The Acne-QoL survey (an acne-specific psychometric survey) has 19 items in four domains (self-perception, role-emotional, role-social, and acne symptoms).

In a recent study, which included 2,813 patients, significant improvements were reported in all four domains in patients who were treated with a fixed combination of clindamycin phosphate 1.2% and benzoyl peroxide (BPO) 2.5% aqueous gel, compared with patients who were treated with individual ingredients or a vehicle for 12 weeks (Cutis 2010;86:263-7). The fixed clindamycin-BPO combination had already been shown to be an effective acne treatment (J. Am. Acad. Dermatol. 2008;59:792-800).

Dr. Saitta and colleagues used statistical formulas to find the most valuable 4-question combination from the results of the 19-item Acne-QoL survey that was used in previous studies. They narrowed the results down to the following four questions:

• How dissatisfied with your appearance do you feel?

• How upset are you about having facial acne?

• How concerned or worried are you about meeting new people?

• How concerned or worried are you about scarring?

Each question is ranked from 0 to 6, with 6 being the worst score.

Statistical regression analysis results showed that although the Acne-Q₄ scores would have been similar at baseline, by week 12, Acne-Q₄ scores would have increased by 59% in patients who were treated with the clindamycin-BPO combination, compared with a 36% increase in the vehicle group.

"Even the 36% change in the vehicle group shows the important psychological impact that both the patient-doctor relationship and office visits can have on improving the mental outlook of patients with acne," said Dr. Saitta.

He added that he hoped the four-question survey will be used in more research studies and by private practitioners to assess "the impact of acne and its treatment on [health-related quality of life] in a clinical practice setting" in which time with patients is at a premium.

He added that with the "new positive results of this four-question, fast survey, I do plan on bringing these up-to-date benefits to my private practice patients."

The authors noted that a limitation of Acne-Q₄ may be "in the selection of one item from each domain."

Dr. Saitta had no relevant disclosures. The study was funded by Valeant Dermatology.

 

 

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