Impact of Female Acne on Patterns of Health Care Resource Utilization
February 2015 | Volume 14 | Issue 2 | Original Article | 140 | Copyright © 2015
Hilary E. Baldwin MD FAAD,a Ariane K. Kawata PhD,b Selena R. Daniels PharmD MS,c
Teresa K. Wilcox PhD,b Caroline T. Burk PharmD MS,d Emil A. Tanghetti MDe
aState University of New York (SUNY) Downstate Medical Center, Brooklyn, NY
bEvidera, Bethesda, MD
cAllergan Inc., Irvine, CA
dHealth Outcomes Consultant, Laguna Beach, CA
eThe Center for Dermatology and Laser Surgery, Sacramento, CA
BACKGROUND: Limited data are available on acne treatment patterns in females through their adult years.
OBJECTIVE: The purpose of this analysis was to evaluate health care resource utilization (HRU) and treatment patterns in cohorts with and without the use of acne medication and predictors of use.
METHODS: A cross-sectional, web-based survey was administered to US females (25–45 years) with facial acne (≥25 visible lesions). Data collected included: sociodemographics and self-reported clinical characteristics, acne treatments, and health care professional (HCP) visits. Subject characteristics associated with medication use were examined by logistic regression.
RESULTS: Approximately half of the total sample (N=208, mean age: 35±6) ever visited an HCP for acne and reported more over-the counter (OTC) medication use (51.0%) than prescription (Rx) medication use (15.4%). Subjects did not use medications daily, averaging from 12–18 days over the previous 4 weeks. Logistic regression showed that race and prior HCP visits for acne were significant predictors of medication use (P<.05).
CONCLUSIONS: Adult females generally self-treated their acne using primarily OTC medications; however, poor compliance was observed for Rx and OTC. Race and prior HCP visits for acne were significant predictors of current medication use.
J Drugs Dermatol. 2015;14(2):140-148.
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Acne vulgaris (acne) has typically been regarded as an adolescent condition, but is also common among adults (≈22% females; ≈3% males).1-4 Despite the high prevalence of adult female acne (AFA), limited research has investigated the clinical presentation, treatment management, and health care resource utilization (HRU) for the condition.
Acne treatments are recommended based on acne severity, disease duration, treatment response, predisposition to scarring and post-inflammatory hyperpigmentation (PIH), patient preference, adherence, and cost.5,6 Based on American Academy of Dermatology guidelines,7 topical therapy is standard of care in acne treatment. First line topical therapies include retinoids, antibiotics, and benzoyl peroxide (BP).6,7 Existing treatment paradigms combine standard, adjunctive, and cosmetic therapies to achieve optimal clinical outcomes, but are not specific to AFA. Consequently, a standardized, evidence-based algorithm is needed to manage the diverse and personalized treatment approach with females in their adult years.5,8
Despite the high prevalence of AFA and known morphological differences between adolescents and adults, limited data are available on HRU specific to females through their adult years, emphasizing the need for additional research. The primary objective of this study was to evaluate the impact of facial acne on patterns of HRU in females through their adult years to better understand standard of care management and increase awareness of unmet needs.
This cross-sectional, web-based, observational survey was conducted in the US in October-November 2011. The survey screened for subject-reported signs consistent with acne and captured data on sociodemographic, clinical characteristics, and HRU. The study was approved by Ethical & Independent Review Services. Additional details on study design and methodology are described elsewhere.9,10
Study Population: Recruitment and Screening
All subjects were recruited through the YouGov Panel (Palo Alto, CA) from a US pool of registered panelists ≥18 years of age. Eligible panelists were females ages 25-45 years; had an active e-mail address at the time of study invitation; able to read and understand English; had presence of self-reported acne (≥25 visible facial lesions); and fulfilled age and/or race/ethnicity sampling targets.