Internet-based communication improves teenagers' use of topical acne therapy

Tech-savvy teens with acne used their medicine more frequently when they also took part in a web-based survey, a new study from Wake Forest Baptist Medical Center finds.

Investigators at Wake Forest Baptist decided to test whether a weekly Internet-based communication could improve teenagers' use of topical acne therapy. And it did.

"Dermatologists have a number of effective topical agents for acne treatment, but patients often do not use their medications as prescribed," said Steve Feldman, M.D., Ph.D, lead author of the study. "Medication use by teens tends to increase around the time of office visits, but this isn't helpful."

The study is published in the October issue of Archives of Dermatology. For this investigator-blinded, randomized, prospective study, Feldman and colleagues enlisted 20 male and female participants, aged 13 to 18 years, with mild to moderate acne. The teens were prescribed topical benzoyl peroxide, 5 percent gel, daily for 12 weeks. They were randomized 1:1 to a control group or to an Internet-based survey group. Those in the Internet survey group were sent a weekly e-mail containing a link to a survey assessing their acne severity and treatment. They answered a total of six questions that addressed how they used the medication.

If participants in the Internet survey group completed at least five surveys during a 6-week period, they received a $5 gift card for Amazon.com. In addition, each completed survey provided them an additional chance to win an iPod Nano at the study conclusion.

Medication use was monitored objectively with electronic monitors that recorded the date and time when the medication containers were opened. Adherence was rated as a percentage of days the medication container was opened. The mean adherence rate was 89 percent for the Internet survey group and 33 percent for the control group. Their acne severity was also evaluated with a rating scale as well as by inflammatory and noninflammatory lesion counts at the beginning of the study, at week six, and week 12.

"Adolescents are savvy users of the Internet and other newer technologies, and we found they responded well to the online survey," Feldman said. "We believe the weekly survey may have served as a 'virtual office visit.' Increasing our understanding of what is needed to get teens to use the medication as prescribed will provide better treatment outcomes for patients."