Williamson Todd, Cheng Wendy Y, McCormick Nora, Vekeman Francis
Vice President, US Medical Affairs, Bayer Pharmaceuticals, Whippany, NJ.
Manager, Analysis Group, Boston, MA.
Am Health Drug Benefits. 2018 Apr;11(2):97-106.
Rosacea is a chronic inflammatory skin disorder that primarily affects the convexities of the central face. Depending on the severity and type of rosacea, physicians may prescribe interventions such as behavioral changes, laser and intense pulsed light, as well as various pharmacologic therapies, including topical agents. The impact of side effects associated with topical treatments for rosacea on patient preferences and treatment satisfaction is not well-documented.
To assess patients' concerns, treatment satisfaction, and quality of life (QOL) associated with topical treatments for rosacea.
Patients were identified for participation in a one-time survey from electronic medical records between 2010 and 2015 from the largest privately held and physician-run multispecialty group practice in Massachusetts. Patients were eligible to participate in the survey if they were aged ≥18 years and had ≥1 diagnoses of rosacea, ≥1 prescriptions for topical metronidazole gel/cream or azelaic acid gel, ≥6 months of follow-up, and an active treatment record in 2014. Treatment-related concerns and their importance were assessed using a questionnaire developed for this study. Treatment satisfaction and QOL were evaluated using the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) and the Dermatology Life Quality Index (DLQI), respectively.
Of the 900 eligible patients surveyed, 216 (24%) responded. Among the responders, 122 reported currently using a topical rosacea treatment. The most common treatment-related concerns were efficacy (64.8%), skin dryness (18.4%), unspecified side effects (9.6%), burning sensation (8.8%), and application technique (8.0%). The treatment-related concerns that were assessed as most important by responders included efficacy (mean score 9.1, on a 10-point scale), soreness (7.6), itching (7.5), burning (7.4), and dryness (7.3). Averaged across all the responders, treatment satisfaction was rated as neutral (mean SATMED-Q score, 56.5), whereas the impact of rosacea on QOL was minimal (mean DLQI score, 2.7). Increasing dryness was significantly associated with worsening QOL, and trends toward significance were observed for increasing soreness, itching, and burning sensations.
The survey results suggest a need for novel topical therapies for patients with rosacea that have increased efficacy and tolerability, which may improve patient satisfaction and QOL.
酒渣鼻是一种慢性炎症性皮肤病，主要影响面部中央的突出部位。根据酒渣鼻的严重程度和类型，医生可能会开出一些干预措施，如行为改变、激光和强脉冲光治疗，以及各种药物治疗，包括局部用药。酒渣鼻局部治疗相关副作用对患者偏好和治疗满意度的影响尚无充分记录。
评估酒渣鼻局部治疗相关的患者担忧、治疗满意度和生活质量（QOL）。
从马萨诸塞州最大的私人执业和医生主导的多专科集团诊所2010年至2015年的电子病历中确定患者参与一次性调查。年龄≥18岁、有≥1次酒渣鼻诊断、≥1次外用甲硝唑凝胶/乳膏或壬二酸凝胶处方、随访≥6个月且2014年有活跃治疗记录的患者有资格参与调查。使用为本研究开发的问卷评估与治疗相关的担忧及其重要性。分别使用药物治疗满意度问卷（SATMED-Q）和皮肤病生活质量指数（DLQI）评估治疗满意度和生活质量。
在900名符合条件的调查患者中，216名（24%）做出了回应。在回应者中，122名报告目前正在使用酒渣鼻局部治疗。最常见的与治疗相关的担忧是疗效（64.8%）、皮肤干燥（18.4%）、未明确的副作用（9.6%）、烧灼感（8.8%）和应用技术（8.0%）。回应者认为最重要的与治疗相关的担忧包括疗效（平均评分9.1，满分10分）、酸痛（7.6）、瘙痒（7.5）、烧灼感（7.4）和干燥（7.3）。在所有回应者中，治疗满意度评分为中性（平均SATMED-Q评分为56.5），而酒渣鼻对生活质量的影响最小（平均DLQI评分为2.7）。干燥加剧与生活质量恶化显著相关，酸痛、瘙痒和烧灼感加剧也有显著趋势。
调查结果表明，需要为酒渣鼻患者开发新的局部治疗方法，提高疗效和耐受性，这可能会提高患者满意度和生活质量。
