Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.
Acta Derm Venereol. 2012 May;92(3):236-40. doi: 10.2340/00015555-1331.
Patients often have preconceived notions about acne treatments before visiting dermatologists. The aim of this study was to explore the association between patients' beliefs regarding acne and physicians' suggestion for treatment modality in dermatology clinics. A cross-sectional, nationwide multicentre study was conducted. A total of 1,370 patients completed questionnaires about beliefs about acne treatment before seeking medical care, and 101 dermatologists assessed their acne severity and proposed treatment methods. We found that patients had preconceptions in understanding disease characteristics, assessing subjective acne severity and preferring specific treatment modalities. Dermatologists' determination of topical agents as first-line treatment was affected by disease severity and patients' preferences. They were also more likely to prescribe isotretinoin even in moderate acne compared to oral antibiotics and topical agents. Selections of physical treatments and light-based therapies were affected by patients' preferences, subjective self-evaluation and dermatologists' assessments. Thus, we suggest that acne treatment strategies should incorporate both patients' subjective perceptions and objective clinical practices into a management paradigm.
患者在就诊皮肤科医生之前，通常对痤疮治疗有先入为主的观念。本研究旨在探讨皮肤科诊所中患者对痤疮的信念与医生建议的治疗方式之间的关联。进行了一项横断面、全国性多中心研究。共有 1370 名患者在寻求医疗护理前完成了关于痤疮治疗信念的问卷，101 名皮肤科医生评估了他们的痤疮严重程度并提出了治疗方法。我们发现，患者在理解疾病特征、评估主观痤疮严重程度和偏爱特定治疗方式方面存在成见。皮肤科医生将局部药物作为一线治疗的决定受到疾病严重程度和患者偏好的影响。他们甚至更有可能开出异维 A 酸，即使是中度痤疮，也比口服抗生素和局部药物更有可能开出异维 A 酸。物理治疗和光疗的选择受到患者偏好、主观自我评估和皮肤科医生评估的影响。因此，我们建议痤疮治疗策略应将患者的主观感知和客观临床实践纳入管理模式。
