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Acne Treatment Algorithm Associated With a Lower Rate of Referrals

A recent study showed a decision-support algorithm was associated with modestly reduced rates of acne-related referrals to dermatologists, as well as an increased likelihood of the referring clinician initiating treatment.

Acne is a common reason for primary care clinicians to refer patients to dermatologists, the researchers noted. They had previously modeled the impact of algorithm-based acne care in reducing dermatology referrals, missed appointments, and treatment delays.

In the prospective cohort study, the researchers evaluated the downstream outcomes following a real-time algorithm-based electronic decision-support tool on the treatment of acne at 33 primary care sites affiliated with Brigham and Women’s Hospital from March 2017 through March 2018. They developed a support tool in the electronic medical record system that identified patients referred to a dermatologist who had not previously been treated for acne and offered guideline-based recommendations for treatment via real-time notification.
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A total of 260 treatment-naïve patients referred to a dermatologist for acne were included in the study, of whom 209 were women (80.4%), 146 were non-Hispanic white (56.1%), and 185 had private insurance (71.1%). The main outcome included treatment modifications by referring clinicians.

Overall, the researchers found the algorithm was associated with cancellation of the initial referral in 35 out of 260 instances (13.5%). The algorithm was also associated with treatment initiation by the referring clinician in 51 out of 260 instances (19.6%).

“This decision-support algorithm was associated with a modest reduction in rates of acne-related referrals to dermatologists, and an increased likelihood of treatment initiation by the referring clinician,” the researchers concluded.

Reference

Li DG, Pournamdari AB, Liu KJ, Laskowski K, Joyce C, Mostaghimi A. Evaluation of point-of-Care decision support for adult acne treatment by primary care clinicians [published online March 04, 2020]. JAMA Dermatol. doi:10.1001/jamadermatol.2020.0135

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