Most PCPs reluctant to prescribe acne treatments

A Best Practice Advisory tool that is part of the EPIC electronic health record system failed to change most primary care physician behaviors when it came to prescribing acne treatments, according to findings presented at the society’s annual meeting.

“Our prior work demonstrated high no-show rates among patients being referred to dermatologists for a primary concern of acne. Patients were often not initiated on acne treatment by the referring provider, leading to delayed and/or no treatment,” Arash Mostaghimi, MD, MPH, MPA, FAAD, of the department of dermatology at Brigham and Women’s Hospital, told Healio Family Medicine.

This previous study that Mostaghimi alluded to found that 50.2% of the 253 patients seeing a dermatologist had not received a prescription for their acne at the time they were referred to that specialist.

In the new study, Mostaghimi and colleagues provided 139 PCPs with the Best Practice Advisory tool, an algorithmic approach intended to be used with patients who have an appointment with their PCP for assessment of acne who do not have a documented prescription acne treatment and have not been seen by a dermatologist for acne in the past 12 months. When the PCP enters an ambulatory referral to dermatology for the acne, the tool triggers a treatment option that the PCP could initiate based on the severity of the acne.

Researchers found that the tool changed referral behavior in 27 of 139 PCPs, with the remainder choosing to refer the patient to a dermatologist without starting treatment. Of the 116 patients referred to a dermatologist, 20 canceled the follow-up appointment, 14 received treatment from their PCP, three were lost to follow-up and three were treated by a different clinician.

“While many providers may continue to refer acne patients to dermatologists, for some patients, treatment in primary care is more efficient and likely equally efficacious for mild to moderate acne,” Mostaghimi said in the interview.

“Health care providers should integrate the most updated research findings to benefit their patient population and use the Best Practice Advisory tool to reduce patient wait time and excessive dermatology utilization,” he said. – by Janel Miller

Reference:

Li, DG, et al. Point-of-care decision support for appropriate acne management. Presented at: American Academy of Dermatology annual meeting; Feb. 16-20, 2018; San Diego.

Disclosure: Healio Family Medicine could not confirm relevant financial disclosures at the time of publication.