A Four-question Approach to Determining the Impact of Acne Treatment on Quality of Life

Facial acne vulgaris can have profound effects on health-related quality of life. In some studies, patients with acne vulgaris reported results similar to those noted with other chronic diseases, such as asthma, arthritis, or diabetes. Clinical objective assessments alone do not adequately capture the impact of acne vulgaris severity from a patient's perspective. Health-related quality-of-life assessment is important in order to fully characterize the overall burden of disease and effectiveness of treatment as the perspectives of the patient are also taken into account. Previous studies of the impact of acne vulgaris treatment on health-related quality of life have been limited in their scope of assessment. Drawbacks of prior studies have included small numbers of patients, health-related quality-of-life parameters that were not adequately evaluated, inclusion of only a limited range of mild-to-moderate acne vulgaris severity, or being unblinded or observational in study design. The Acne Quality of Life is an acne-specific questionnaire developed to assess treatment impact on the health-related quality of life of patients with acne vulgaris. Its psychometric properties and degree of responsiveness are well-established. Improvement in Acne Quality of Life with the fixed combination clindamycin phosphate 1.2%/benzoyl peroxide 2.5% aqueous gel in the largest cohort of acne vulgaris patients where health-related quality of life was studied has been reported recently. Significant improvements in all four domains over 12 weeks were seen with clindamycin phosphate 1.2%/benzoyl peroxide 2.5% aqueous gel compared to patients treated with individual active ingredients or vehicle (p<0.001). Length and time required for completion of the 19-item Acne Quality of Life questionnaire is likely to preclude its use in clinical practice. A condensed, validated Acne Q-4 scale based on the four items most broadly representative of health-related quality of life combined with a high level of correlation to the Acne Quality of Life questionnaire has been suggested as a more realistic approach that may be applied by clinicians when managing patients with acne vulgaris. The authors present data on the effectiveness of clindamycin phosphate 1.2%/benzoyl peroxide 2.5% aqueous gel on health-related quality of life based on this Acne Q-4 scale.