Effect of Automated Online Counseling on Clinical Outcomes and Quality of Life Among Adolescents With Acne Vulgaris

Abstract

IMPORTANCE Effective patient education is necessary for treating patients with acne vulgaris. Automated online counseling simulates face-to-face encounters and may be a useful tool to deliver education. OBJECTIVE To compare the effectiveness of a standard educational website with that of an automated-counseling website in improving clinical outcomes and quality of life among adolescents with acne. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial conducted between March 27, 2014, and June 27, 2014, including a 12-week follow-up in a local inner-city high school. Ninety-eight students aged at least 13 years with mild to moderate acne were eligible for participation. A per-protocol analysis of the evaluable population was conducted on clinical outcome data. INTERVENTIONS Participants viewed either a standard educational website or an automated-counseling website. MAIN OUTCOMES AND MEASURES The primary outcome was the total acne lesion count. Secondary measures included the Children’s Dermatology Life Quality Index (CDLQI) scores and general skin care behavior. RESULTS Forty-nine participants were randomized to each group. At baseline, the mean (SD) total acne lesion count was not significantly different between the standard-website group and the automated-counseling–website group (21.33 [10.81] vs 25.33 [12.45]; P = .10). Improvement in the mean (SD) acne lesion count was not significantly different between the standard-website group and the automated-counseling–website group (0.20 [9.26] vs 3.90 [12.19]; P = .10). The mean (SD) improvement in CDLQI score for the standard-website group was not significantly different from that of the automated-counseling–website group (0.17 [2.64] vs 0.39 [2.94]; P = .71). After 12 weeks, a greater proportion of participants in the automated-counseling–website group maintained or adopted a recommended anti-acne skin care routine compared with the standard-website group (43% vs 22%; P = .03). CONCLUSIONS AND RELEVANCE Internet-based acne education using automated counseling was not superior to standard-website education in improving acne severity and quality of life. However, a greater proportion of participants who viewed the automated-counseling website reported having maintained or adopted a recommended anti-acne skin care regimen. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02031718

Quality of life measurement in acne. Position Paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa

“…Mean DLQI and CADI scores improved after 12 weeks of text messages and multiple‐choice questions . Internet‐based acne education using automated counselling was not superior to standard website education in improving acne severity and QoL …”

“…Most of the publications identified were clinical trials, epidemiologic studies and studies on creation and/or validation of QoL instruments. However, there were also publications on educational work in acne patients, compliance and adherence to treatment, correlation of QoL with acne severity measures, psychological problems, gender differences, racial differences, comparison of generic and disease‐specific QoL instruments, and comparison of QoL impairment in patients with acne and other diseases …”

A Comparison of Quality of Life of Patients in Public and Private Hospitals Admitted with Acne Vulgaris

“…Ölçek, semptom, fonksiyon ve emosyon skalalarından oluşmaktadır. Ölçekte 1, 7, 10, 16, 19, 24, 27 nolu sorular semptom, 2,4,5,8,11,14,17,20,22,25,29, 30 nolu sorular fonksiyon, 3,6,9,12,13,15,21,23,26, 28 nolu sorular emosyon skalasını oluşturmaktadır. Ölçekteki cevaplar "aHiçbir zaman: 0, b-Nadiren: 25, c-Bazen: 50, d-Sıklıkla: 75, e-Her zaman: 100" olacak şekilde lineer skalaya çevrilerek semptom, fonksiyon ve emosyon skalalarının ortalaması elde edilmiştir.…”

“…AV'li hastalarda yaşam kalitesini değerlendirmek amacı ile farklı ölçekleri kullanan birçok çalışma yapılmıştır (6)(7)(8). Yapılan bir çalışmada akne grubu hastalıklar özel muayenehaneye en sık (%15,2) başvuru nedeni iken, kamu hastanesine ikinci sıklıkta (%15,8) başvuru nedenini oluşturmuştur (9).…”

Conceptualization, development and validation of T‐QoL©(Teenagers’ Quality of Life): a patient‐focused measure to assess quality of life of adolescents with skin diseases

“…The impact of skin diseases is based predominantly on adolescents’ subjective perceptions of their condition, rather than on objective clinical measures . Other QoL measures focused on the concerns of adolescents include acne‐specific measures, as acne primarily affects this age group . However, when measuring QoL in adolescence, researchers have generally used measures designed to be used across childhood .…”