title: Adherence to drug treatments and adjuvant barrier repair therapies are key factors for clinical improvement in mild to moderate acne: the ACTUO observational prospective multicenter cohort trial in 643 patients.
abstract: BACKGROUND
  In acne, several studies report a poor adherence to treatments. We evaluate, in a real-life setting conditions, the impact of compliance to physician's instructions, recommendations and adherence to the treatments on clinical outcome in patients with mild to moderate acne in an observational, non-interventional prospective study carried out in 72 Dermatologic Services in Spain (ACTUO Trial).
  
  
  METHODS
  Six-hundred-forty-three subjects were enrolled and 566 patients (88 %) completed the 3 study visits. Study aimed to evaluate the impact of adherence (assessed with ECOB scale) on clinical outcome, as well as how the use of specific adjuvant treatments (facial cleansing, emollient, moisturizing and lenitive specific topical products) influences treatment's adherence and acne severity (0-5 points score). Recommendation of specific adjuvant skin barrier repair products was made in 85.2 %.
  
  
  RESULTS
  Overall, clinical improvement was observed throughout follow-up visits with an increased proportion of patients who reported reductions of ≥50 % on the total number of lesions (2 months: 25.2 %; 3 months: 57.6 %) and reductions of severity scores (2.5, 2.0 and 1.3 at 1, 2 and 3 months after treatment, respectively). Adherence to treatment was associated with a significant reduction on severity grading, a lower number of lesions and a higher proportion of patients with ≥50 % improvement.
  
  
  CONCLUSIONS
  Good adherence to medication plus adherence to adjuvants was significantly associated with a higher clinical improvement unlike those that despite adherence with medication had a low adherence to adjuvants. A good adherence to adjuvant treatment was associated with improved adherence and better treatment outcomes in mild to moderate acne patients. (ISRCTN Registry: ISRCTN14257026).
authors.affiliation: Hospital Universitario La Paz, Madrid, Spain. rauldelucas@gmail.com.
authors.forename: Raúl
authors.initials: R
authors.lastname: de Lucas
authors.affiliation: Hospital Quirón Teknon, Barcelona, Spain. gerardomoreno@fundacionteknon.com.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Moreno-Arias
authors.affiliation: Clínica Dermatológica de Moragas, Barcelona, Spain. montserratperez@gmail.com.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Perez-López
authors.affiliation: Hospital Carlos Haya,, Málaga, Spain. angelveracasano@gmail.com.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Vera-Casaño
authors.affiliation: Isdin S.A. Medical Department, Provençals 33, Barcelona, Spain. sonia.aladren@isdin.com.
authors.forename: Sonia
authors.initials: S
authors.lastname: Aladren
authors.affiliation: Isdin S.A. Medical Department, Provençals 33, Barcelona, Spain. massimo.milani@isdin.com.
authors.forename: Massimo
authors.initials: M
authors.lastname: Milani
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004643:Emollients / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D011446:Prospective Studies; D012176:Retinoids / Q000627:therapeutic use; D012720:Severity of Illness Index; D063465:Skin Cream / Q000627:therapeutic use; D012915:Soaps / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D003879:Dermatologic Agents; D004643:Emollients; D012176:Retinoids; D012915:Soaps