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There is a theory that professional acne care can be effective not only in decreasing clinical signs but also in improving quality of life.
Femke de Vries, MD, department of dermatology, Radboud University Medical Center in Nijmegen, Netherlands, led a study designed to discover a better understanding of the association between quality of life (QoL) and physician-led acne care. The study, “The association between acne care provision and quality of life: A cross-sectional survey,” also investigated other factors that might influence QoL such as age, gender, and acne severity.
“Since acne is often considered a cosmetic and non-life-threatening skin condition, the consequences are frequently overlooked medically,”de Vries wrote in the study. “Acne can have a profound negative psychological impact with implications for patients’ health related quality of life. In order to improve the quality of the Dutch dermatological care provision, a more personalized patient-centered care is recommended.”
This more personalized approach includes facilitating the integration of measuring QoL into routine clinical practice, she continued. To do so, de Vriesnoted, it is important to gain a better understanding of the factors influencing the QoL in the acne population and which patients would benefit most from measuring QoL in routine clinical practice.
To gather data on the impact of acne vulgaris on health-related QoL, a cross-sectional, questionnaire-based study was conducted utilizing the Cardiff Acne Disability Index (CADI) and a global QoL scale to capture the QoL within the Dutch acne population. This data was then examined for QoL factors. The study was reported according to the recommendations in the Strengthening the Reporting of Observational Studies in Epidemiology checklist.
“Furthermore, to investigate the association of QoL with acne severity we used the Patient Reported Global Assessment (PGA)-severity scale,”de Vries said. “We analyzed several factors that derived from literature and could potentially influence the QoL, such as acne severity, the type of care provider providing treatment, age, and gender.”
The CADI contained 5 questions to gather QoL data points, including patients’ feelings when dealing with acne, social life, skin exposure, and overall acne severity assessment by the patient. The questionnaire also contained a global QoL scale, to give the patients the opportunity to report QoL improvement experienced before and after care.
In total, 371 CADI questionnaires were completed, though 9 were dismissed due to incomplete data. The study population consisted of 79% females and 21% males and was conducted between 2019 and 2020.
No statistically significant differences were found in QoL measured by CADI among patients visiting the 4 investigated acne caregivers (mean CADI score: dermatologist, 4.49; GPs, 4.42; dermal therapist, 4.07; beautician, 4.20, P = .24). However, the impact of the treatment on the QoL, which was measured by the level of global QoL improvement before and after care,demonstrated a statistically significant improvement when attending a dermatologist, compared to the care provided by beauticians.
“The study delineated factors that influence QoL in acne patients,” she said. “As the QoL was not associated with the type of caregiver, the greatest QoL improvement before and after care was achieved after medical treatment by the dermatologist.”
Discrepancies were found for the influence of age on QoL. de Vries noted previous studies have demonstrated a greater impact on QoL in older patients with acne than in younger patients; however, the study authors were not able to detect this difference, citing the small number of respondents over 40 years old involved.
What it did learn was patients dealing with more severe acne experienced a more effected QoL. de Vries said it is recommended to take these factors into account in acne management to optimize professional treatment in line with patient needs.
“I think that the most important message coming from this research is that several identified factors (females and more severe acne) influence the QoL and professional treatment can improve the QoL in acne patients,” de Vries said.
The study authors recommend taking these factors into account in acne management and guidance of patients to optimize professional treatment in line with patient needs.
“We were not surprised finding results that underlined the fact that dealing with acne influence the QoL; however, from a certain degree of acne severity (i.e. corresponding to moderately to severe acne), the level of QoL impairment did not increase, indicating that the magnitude of acne on a person’s QoL was almost equal among more severe types of acne.”
Buidling on this knowledge shows that identifying the possible value of caregivers on the acne related QoLmay contribute to adopting QoL measures as an integral part of acne management, the study authors found. This identification may improve acne care in clinical practice and create treatment more in line with the patients' needs.
Based on these conclusions, the study authors are encouraged to use QoL measurements in clinical practice as a substantial indicator in delivering high quality of care, that is more in line with the patients’ needs.
“Due to the high impact of acne on patients’ lives, adopting a QoL measure as an integral part of acne management is highly recommended and benefits both the patient and the care (provider) in many ways,” de Vries said.
de Vries F, Driessen R, Tjin E, Westenberg A, Vehof H, van de Kerkhof P. The association between acne care provision and quality of life: A cross-sectional survey. Health Sci Rep. 2022;5(2):e487. doi:10.1002/hsr2.487