title: Effect of Automated Online Counseling on Clinical Outcomes and Quality of Life Among Adolescents With Acne Vulgaris: A Randomized Clinical Trial.
abstract: OBJECTIVE
  Effective patient education is necessary for treating patients with acne vulgaris. Automated online counseling simulates face-to-face encounters and may be a useful tool to deliver education.
  
  
  OBJECTIVE
  To compare the effectiveness of a standard educational website with that of an automated-counseling website in improving clinical outcomes and quality of life among adolescents with acne.
  
  
  METHODS
  Randomized clinical trial conducted between March 27, 2014, and June 27, 2014, including a 12-week follow-up in a local inner-city high school. Ninety-eight students aged at least 13 years with mild to moderate acne were eligible for participation. A per-protocol analysis of the evaluable population was conducted on clinical outcome data.
  
  
  METHODS
  Participants viewed either a standard educational website or an automated-counseling website.
  
  
  METHODS
  The primary outcome was the total acne lesion count. Secondary measures included the Children's Dermatology Life Quality Index (CDLQI) scores and general skin care behavior.
  
  
  RESULTS
  Forty-nine participants were randomized to each group. At baseline, the mean (SD) total acne lesion count was not significantly different between the standard-website group and the automated-counseling-website group (21.33 [10.81] vs 25.33 [12.45]; P = .10). Improvement in the mean (SD) acne lesion count was not significantly different between the standard-website group and the automated-counseling-website group (0.20 [9.26] vs 3.90 [12.19]; P = .10). The mean (SD) improvement in CDLQI score for the standard-website group was not significantly different from that of the automated-counseling-website group (0.17 [2.64] vs 0.39 [2.94]; P = .71). After 12 weeks, a greater proportion of participants in the automated-counseling-website group maintained or adopted a recommended anti-acne skin care routine compared with the standard-website group (43% vs 22%; P = .03).
  
  
  CONCLUSIONS
  Internet-based acne education using automated counseling was not superior to standard-website education in improving acne severity and quality of life. However, a greater proportion of participants who viewed the automated-counseling website reported having maintained or adopted a recommended anti-acne skin care regimen.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT02031718.
authors.affiliation: Department of Dermatology, University of California, Davis, Sacramento.
authors.forename: William
authors.initials: W
authors.lastname: Tuong
authors.affiliation: Department of Dermatology, University of California, Davis, Sacramento.
authors.forename: Audrey S
authors.initials: AS
authors.lastname: Wang
authors.affiliation: Department of Dermatology, University of Colorado, Denver, Aurora.
authors.forename: April W
authors.initials: AW
authors.lastname: Armstrong
mesh_terms: D000152:Acne Vulgaris / Q000523:psychology / Q000628:therapy*; D000293:Adolescent; D003376:Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D015436:Panniculitis, Peritoneal; D010353:Patient Education as Topic / Q000379:methods*; D011788:Quality of Life; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult