Implementation of a Cost-Effective Treatment Algorithm for the Management of Acne Vulgaris in College Students

Acne is one of the most common skin disorders in the United States, occuring in over 5.1 million Americans. Of those with acne, 53.8% are adults between the ages of 18 and 44 years old (American Academy of Dermatology [AAD], 2017). Acne can lead to multiple issues such as scarring, poor self-esteem, anxiety, and depression (Zaenglein et al., 2016). Acne can also negatively impact quality of life (Cengiz & Gurel, 2020). The purpose of this evidence-based project was to develop a cost-effective treatment algorithm for the management of acne vulgaris in adult college students. A literature search determined the best and most cost-effective agents to manage acne are benzoyl peroxide 2.5%, adapalene 0.1%, clindamycin phosphate 1%, and doxycycline. These agents are used in varying combinations based on acne severity level, which can range from clear, almost clear, mild, moderate, severe, and very severe. A treatment algorithm was developed based on the literature recommendations and implemented by two nurse practitioners at a university student health center located in Northwest Indiana. Two groups of participants were included in this study, an intervention group that received treatment and a comparison group that did not receive treatment. The primary outcome being measured was participant quality of life measured by the Acne-Specific Quality of Life (Acne-QoL) Questionnaire, which is separated into four specific domains. Participants completed this questionnaire during baseline visits and again after 6 weeks of treatment. Data were analyzed using paired-samples t tests for both the intervention and comparison groups, as well as a mixed-design ANOVA between groups. For the intervention group there were statistically significant increases in quality of life for the self-perception (t (9) = -3.171, p = .011), role-emotional (t (9) = -2.675, p = .025), and acne symptoms (t (9) = -3.48, p = .007) domains. No statistically significant difference was found between mean baseline and 6-week scores for the comparison ...