Treatment algorithm may help primary care providers optimize acne care

Using an algorithm to determine treatment of mild-to-moderate acne may help primary care physicians to streamline patient care, according to research presented at the American Academy of Dermatology Annual Meeting.

Kristina J. Liu, MD, Harvard Combined Dermatology Residency Program, and colleagues found that utilization of a specific treatment algorithm may eliminate unnecessary appointments, in turn reducing wait times for treatment, costs and no-shows.

"The referral of acne patients from PCPs to dermatology is an inefficient process resulting in long wait-times and frequent no-shows," the researchers wrote in the abstract. "In this project, we model the impact of algorithm-based acne treatment by primary care on referrals to dermatology."

Liu and colleagues retrospectively reviewed electronic acne referrals from PCPs to dermatologists at Brigham and Women's Hospital from January 2014 through March 2015. They applied two treatment algorithms to estimate changes in wait time, cost and missed appointments.

One algorithm consisted of initiation of topical treatments and the other consisted of initiation of topical treatments and oral antibiotics.

In the study period, 253 patients were referred for acne and 151 were seen by a dermatologist and had their acne diagnosis confirmed. The researchers found that patients waited a median of 19 days from referral to appointment and 50.2% of patients did not receive any treatment prior to referral.

Liu and colleagues reported that the algorithm in which PCPs prescribed topical treatments resulted in referral elimination for 40% of patients and reduced initial referrals by 48%, leading to a cost decrease of $20.30 and wait-time reduction of 4.8 days per patient.

The algorithm in which PCPs prescribed topical treatments as well as oral antibiotics resulted in referral elimination for 72% of patients and reduced initial referrals by 86.7%, leading to a cost decrease of $36.52 and wait-time reduction of 8.7 days per patient.

The researchers also stated that the algorithms would result in a reduction of 131 and 236 missed appointments per 1,000 patients, respectively.

"By empowering PCPs to treat mild-to-moderate acne, more severely affected patients may gain expedited access to dermatologists," the authors concluded. – by Chelsea Frajerman Pardes

Disclosures: Healio Internal Medicine could not confirm relevant financial disclosures at the time of publication.

Reference:

Liu KJ, et al. Poster #2845. Presented at: American Academy of Dermatology 74th Annual Meeting; March 4-8, 2016; Washington, D.C.