Journal of Clinical and Aesthetic Dermatology

JUN 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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19 JCAD journal of clinical and aesthetic dermatology June 2017 • Volume 10 • Number 6 O R I G I N A L R E S E A R C h linked opt-in process before beginning the survey. United BioSource Corporation (Bluebell, Pennsylvania) monitored the conduct of the survey, which was administered by Ipsos Observer (Paris, France). Potential survey participants were identified by Ipsos Observer through their partnership with four companies utilizing established panels of volunteers who have agreed to participate in surveys. Panelists were not paid for their participation, but received incentives through loyalty programs with a low dollar value. Adult survey panelists who had been prescreened for rosacea received an invitation via e-mail to participate in this survey. The e- mail contained a hyperlink to the survey website, for those who wished to participate. Participant eligibility. Prospective participants had completed an eligibility survey designed to identify those with current ETR or PPR. Eligible participants lived in the United States, were at least 18 years of age, and self-reported a physician's diagnosis of rosacea at any time in the past. Participants were required to be able to read and understand English. Exclusion criteria included self-rated facial redness that was less than mild, based on the validated Self-Assessment of Rosacea Facial Redness (SA-RFR) photographic scale. Additionally, patients with telangiectasia (visible blood vessels) covering more than 25 percent of the area where rosacea occurs, sun-damaged skin (irregular coloring or pigmentation of the skin, with a mottled, wrinkled appearance, and "liver spots" or "age spots") covering more than 25 percent of the face, or acne covering more than 25 percent of the face were excluded. Participants were requested to respond to the eligibility survey in a well-lit room, to remove any makeup or facial jewelry, and to use a mirror. They were also encouraged (but not required) to complete the survey in the evening, after having eaten a meal. Participants who completed the survey and indicated the presence of at least mild facial redness were classified into an ETR or PPR cohort, based on having fewer than four or at least four inflammatory bumps or pimples, respectively, at the time of the survey. Participants were also categorized as having mild, moderate, or severe rosacea. In the ETR cohort, severity was assessed on the basis of facial redness alone using the SA-RFR scale as a photographic guide, while in the PPR cohort, severity was categorized based on the number of facial lesions alone. Subjects who indicated having 4 to 9 facial bumps or pimples were classified as having mild PPR, 10 to 20 as moderate PPR, and 21 or more as severe PPR. Facial redness severity was also assessed for participants in the PPR cohort. Data collection. The survey included basic demographic questions, including sociodemographics, height and weight, type of medical insurance, and whether or not they had prescription drug coverage. Clinical characteristics, including age when rosacea signs and symptoms were first noticed, type of initial rosacea (ETR vs. PPR), bothersomeness of current symptoms, location of rosacea signs and symptoms, the presence of concomitant skin conditions, and the participant's skin type, using the Fitzpatrick skin phototype scale, were also assessed. 3 3 Rosacea was assessed using the SA-RFR and the Symptom Assessment for Rosacea Facial Bumps and Pimples questionnaire, which was based on the SA-RFR. In addition, the survey included questions about coping and avoidance behaviors to prevent rosacea flare-ups, visits to healthcare professionals for their rosacea, use of prescription and over-the-counter (OTC) treatments, scenarios for the use of treatment, and satisfaction with treatment. Questions about treatment satisfaction included the collection of adverse event data. In cases where unwanted effects could be linked to a specific treatment or medication, they were reported to the drug manufacturer within 24 hours. Statistical analysis. Descriptive statistics were reported for sociodemographics, survey metrics, burden of illness, treatment perceptions, and satisfaction with treatment for each cohort. Limited inferential analyses were conducted for key outcomes, with statistical significance for all comparisons set at p<0.01. For continuous variables, comparisons were conducted using the student t-test. For categorical outcomes,

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