Patient Preferences and Therapeutic Satisfaction with Topical Agents for Rosacea: A Survey-Based Study

BACKGROUND: Rosacea is a chronic inflammatory skin disorder that primarily affects the convexities of the central face. Depending on the severity and type of rosacea, physicians may prescribe interventions such as behavioral changes, laser and intense pulsed light, as well as various pharmacologic therapies, including topical agents. The impact of side effects associated with topical treatments for rosacea on patient preferences and treatment satisfaction is not well-documented. OBJECTIVE: To assess patients' concerns, treatment satisfaction, and quality of life (QOL) associated with topical treatments for rosacea. METHODS: Patients were identified for participation in a one-time survey from electronic medical records between 2010 and 2015 from the largest privately held and physician-run multispecialty group practice in Massachusetts. Patients were eligible to participate in the survey if they were aged >= 18 years and had >= 1 diagnoses of rosacea, >= 1 prescriptions for topical metronidazole gel/cream or azelaic acid gel, >= 6 months of follow-up, and an active treatment record in 2014. Treatment-related concerns and their importance were assessed using a questionnaire developed for this study. Treatment satisfaction and QOL were evaluated using the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) and the Dermatology Life Quality Index (DLQI), respectively. RESULTS: Of the 900 eligible patients surveyed, 216 (24%) responded. Among the responders, 122 reported currently using a topical rosacea treatment. The most common treatment-related concerns were efficacy (64.8%), skin dryness (18.4%), unspecified side effects (9.6%), burning sensation (8.8%), and application technique (8.0%). The treatment-related concerns that were assessed as most important by responders included efficacy (mean score 9.1, on a 10-point scale), soreness (7.6), itching (7.5), burning (7.4), and dryness (7.3). Averaged across all the responders, treatment satisfaction was rated as neutral (mean SATMED-Q score, 56.5), whereas the impact of rosacea on QOL was minimal (mean DLQI score, 2.7). Increasing dryness was significantly associated with worsening QOL, and trends toward significance were observed for increasing soreness, itching, and burning sensations. CONCLUSIONS: The survey results suggest a need for novel topical therapies for patients with rosacea that have increased efficacy and tolerability, which may improve patient satisfaction and QOL.