No abstract

No abstract

The current prior authorization (PA) process poses a significant burden on physician practices, particularly in fields with a high rate of medication prescriptions such as dermatology. Such a cumbersome process may deter physicians from advocating for their patients to receive the services they need, significantly delay treatment, and inhibit patient follow-through. To enhance patient compliance, medication access, and ultimately patient care, further knowledge about the PA process for dermatological practices is needed. Past studies have explored the impact of PAs for acne and psoriasis treatments, but how patients with more complex dermatological conditions are impacted is not well understood. To characterize the problem in this patient population, administrative time spent on addressing these PAs for patients with complex dermatological conditions was assessed. For a single provider's dermatologic practice, the start and stop time for administrative activities associated with PAs (e.g. form completion, peer-to-peer dialogue) was tracked over the course of 3 months (n¼30). For each patient with a prescription requiring PA, median administrative time per patient was 30 min (IQR 17.75-72.5 min) resulting in 43% approvals and 46% initial denials (insurer's decision still outstanding for 10%). These patients experienced significant delay to treatment; from time of prescription of medication or diagnostic test to time of receipt of treatment or diagnostic procedure, patients were delayed a median of 11 days (IQR: 6-33.5 d), in addition to unquantifiable distress associated with care and in 2 patient cases, inpatient hospitalization to receive the appropriate medication. Thus, an enhanced understanding of the impact of the PA process on patients with complex needs in both the outpatient and inpatient settings will be critical in designing better systems to streamline the process for independent physician practices and the larger U.S. healthcare system. 569Development of an advanced retinol oil composition with superior bioactivity and anti-aging clinical efficacy Vitamin A or retinol is a proven cosmetic ingredient for the treatment of photoaged skin. It has been incorporated in various product forms which are used in daily skin care regimens. Retinol as an oil form can offer unique aesthetics and physicochemical characteristics. The relative polarity between skin, retinol, and emollient ratios allows for controlled biodelivery of retinol. Retinol induced-bioactivity could be enhanced, and its irritation potential could be mitigated by controlling its delivery rate to skin. Thus, an optimized retinol oil formulation enabling a controlled release of retinol drives better efficacy and lower irritation. An advanced retinol oil was developed through evaluation of the relationship between its composition versus its bioactivity and irritation potential by using clinically correlated standardized biomarker gene expression analysis. This retinol oil composition delivered superior bioactivity with a low irritation potential p...

No abstract

A facial moisturizer incorporating the extract of Myrtus and retinol (ROL) was developed, and previously showed that this ROL complex enhancing ROL activity helps to clinically delay and reduce the signs of skin aging. ROL complex exerts its many skin benefits through transcriptional activation. Recent studies suggest epigenetic regulation through micro-RNAs (miRNAs), specific inhibitors of targeted gene translation, may also play a role in the regulation of skin aging. However, no studies demonstrated retinol's rejuvenating skin benefits could be also associated with epigenetic regulation of miRNAs in human skin. Studies were conducted to discover whether ROL complex's support in the stimulation of anti-aging biomarkers could be associated with transcriptomics and epigenetic changes in miRNA expression in human skin cells. Human adult fibroblasts were treated with either ROL and ROL complex for up to 72 hours. mRNA, miRNA and protein expressions were evaluated. Differentially expressed genes (DEG) induced by ROL were identified and analyzed using Gene Ontology (GO) to identify enriched biological processes. GO enrichment analysis of ROL-treated fibroblasts revealed enrichment for processes related to human skin aging such as extracellular matrix organization. In addition, ROL Complex helped induce ELN gene expression and type I pro-collagen protein production. Concomitantly, ROL Complex also caused epigenetic changes by reducing the expression of multiple miRNAs known to inhibit collagen and elastin genes expression.Thus, ROL complex may also exert its rejuvenating skin benefits through epigenetic regulation of both collagen and elastin that supports increases of extracellular matrix proteins. In conclusion, ROL complex may exert anti-aging skin benefits through a pleiotropic mode of action, uncovering epigenetics as an additional mechanism to explain and enhance its benefits.