Publication:

Drug utilization patterns and adherence in patients on systemic and topical medications for the treatment of acne vulgaris

Background Acne vulgaris is a chronic inflammatory condition of the pilosebaceous units, often causing psychosocial distress and posing a treatment challenge due to poor medication adherence. This study aimed to assess drug utilization patterns and adherence among acne vulgaris patients in a tertiary care teaching hospital.

Methods A prospective cross-sectional study was conducted in the Dermatology Department, in collaboration with the Pharmacology Department, ESIC Medical College and Hospital, Faridabad. A total of 296 prescriptions were collected between November 2022 and July 2023. Patients aged 15–35 years with all grades of acne on treatment for at least six months were included; pregnant women and those with hypertension or diabetes were excluded. Drug use patterns and adherence were analyzed.

Results Across 296 prescriptions, 852 drugs were prescribed (294 oral, 558 topical), averaging 2.87 drugs per prescription. Fixed-dose combinations were used in 210 cases, and polypharmacy was observed in 92.56% of prescriptions. Doxycycline (68.1%) was the most common oral drug, while salicylic acid + glycolic acid (47.6%) and clindamycin + retinoic acid (33.4%) were common topicals. Grade I acne predominated in topical-only users, while grade II was more common in those on combination therapy. Combination therapy showed better adherence (74 versus 67 days), improved clinical outcomes (lower IGA scores), stronger patient-doctor relationships (higher PDDR scores), and more favorable skin pH.

Conclusions Combination therapy is commonly used for moderate acne and is associated with improved adherence, clinical outcomes, and patient engagement, highlighting the benefits of integrated treatment approaches.