Acne vulgaris in the United States: a descriptive epidemiology.

While acne vulgaris is a common skin disease, many misconceptions still exist. The purpose of this study is to provide epidemiologic data to accurately describe the US population affected with acne and its associated comorbidities. Patient information was obtained from a third-party database of administrative claims from more than 80 public and private healthcare plans, representing approximately 9.6 million unique patients, and analyzed using the Total Resource Utilization Benchmarks process. Benchmarks in this study included sex, age, comorbidities, medication, and cost. Nearly two-thirds of visits were made by females (65.2%). Teenagers (age range, 12-17 years) comprised only 36.5% of patients with acne, while patients 18 years or older comprised 61.9%. Depression was reported in 10.6% of females with acne. The average total episode cost across all age groups was determined to be $689.06, with a range of $361.25 (age range, 0-11 years) to $869.06 (age range, 15-17 years). The older patients (age 65+ years) more often were prescribed different medications than younger individuals. This analysis only included patients who sought treatment of their acne and may underestimate the total prevalence of acne in the population. Acne is a disease that affects all age groups, not just adolescents. Differences in age are associated with differences in pharmaceutical treatment as well as total healthcare utilization. Depression is a substantial comorbidity and patients seeking treatment of acne should be screened for depression.

Monitoring for medication errors in outpatient settings.

BACKGROUND: Vigilant reporting of medication errors and adverse drug events (ADEs) is needed to understand and reduce the extent of this problem in dermatology. Various systems are already in place in inpatient settings. OBJECTIVE: To review existing medication error reporting systems related to outpatient settings with emphasis on topical medications associated with dermatological diseases. METHOD: Search terms 'medication error', 'outpatient settings', 'barriers', 'medication use process', 'CPOE' (computerized prescriber order entry), 'dermatological conditions' and 'skin disorders' were used. RESULTS: The rate of medication-related incidents range as high as 4.49 per 1000 to 24.1 per 1000 inpatient days. The most common error type was patient error, accounting for 56% of errors. Other errors that occurred were prescription errors (13%), delivery errors (13%), availability errors (10%), and reporting errors (8%). CPOE systems can increase medication safety, while introducing other problems including faulty computer interface, miscommunication with other systems, lack of adequate decision support, and other human errors (knowledge deficit, distractions, inexperience, and typing errors). CONCLUSION: There is an opportunity for improved tracking and reporting of medication errors in dermatology. Systems are needed to ensure that patients understand how their medication should be used.

The Relationship Between Physician Friendliness and Caring, and Patient Satisfaction: Findings from an Internet-Based Survey.

BACKGROUND: This study examines patient satisfaction with physicians. Patient satisfaction is a quality measure that affects treatment outcomes. More specifically, it examines how a patient's perception of physician friendliness and caring can affect patient satisfaction. METHODS: A cross-sectional survey study was conducted with a convenience sample of 20 901 patients who rated their recent visit to a physician via an internet-based survey. The survey included questions on aspects of overall satisfaction with physician care and office practice as well as more detailed items, including demographics, physician 'friendliness and caring' (collectively referred to as 'empathy' in this paper), time spent with the doctor, and areas that could be improved. Responses to the questions were on a scale from 0 ('not at all satisfied') to 10 ('extremely satisfied'). These scales were then used to represent patient satisfaction. RESULTS: Of the 20 901 patients who participated in the online survey, perceived empathy was the most predominant correlate associated with patient satisfaction with their physician, with a partial correlation of 0.87 (p < 0.001) and a Pearson correlation of 0.92 (p < 0.001). Patient satisfaction with the office setting was also highly correlated with empathy scores, with a partial correlation of 0.72 (p < 0.001) and a Pearson correlation of 0.83 (p < 0.001). Other factors, such as waiting time, and problems with appointments, staff, records, parking, doctor care, and ways of obtaining information, also played a role in patients' overall satisfaction with the physician. CONCLUSIONS: Patient satisfaction ratings are strongly correlated with patient perceptions of physician friendliness and caring.