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Digital health
Structured digital care pathway for systemic acne treatment using isotretinoin
  1. Amandip Sangha1,
  2. Mohammad Rizvi1,2
  1. 1 Askin, Trollåsen, Norway
  2. 2 Department of Dermatology, Oslo University Hospital, Oslo, Norway
  1. Correspondence to Dr Amandip Sangha, Askin, Trollåsen, Viken, Norway; amandip.sangha{at}askin.no

https://doi.org/10.1136/bmjinnov-2021-000917

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    What are the new findings

    • Digital care pathway for treatment of acne using isotretinoin aims to streamline both patient and dermatologist user experience.

    • The digital service is built with care for medical soundness and treatment safety.

    • Communication between patient and doctor is facilitated through frequent message exchanges.

    • Knowledge transfer to patient is addressed.

    • The digital care pathway aims to make the treatment more accessible, and the digital experience more user friendly and efficient.

    • Provides a working example of a modern, teledermatological, digital care pathway for systemic treatment of acne using isotretinoin.

    How might it impact on healthcare in the future

    • More patients (and more treatments) could benefit from using modern digital care pathways.

    • Digitalised health care has the potential for time and cost savings in the health sector.

    • Digital health care gives the patient greater autonomy in the organising of the treatment plan.

    • Closer and more efficient patient–doctor communication digitally.

    • Patients can get more involved and more knowledgeable in the management of their condition when given a user-friendly digital experience.

    Introduction

    Acne is a condition that affects a large portion of the population, especially younger people. The condition is well documented as being a formidable burden on the patient, psychologically and socially. Moreover, the severe forms of acne can leave permanent scars on the skin, if not properly treated. Treatments of acne consist of a range of various topical treatments sometimes combined with antibiotics administered orally. Among the most potent systemic treatment options, there is isotretinoin, which is a vitamin A-derivative. In treating acne, isotretinoin works by

    • Reducing sebum production.

    • Shrinking the sebaceous glands.

    • Reducing follicular occlusion.

    • Inhibiting the growth of bacteria.

    • Having anti-inflammatory effects.

    Isotretinoin is administered orally in the form of capsules that are ingested daily over a longer period of time, typically over a course of 6–12 months. In most cases, the effect of the treatment is prolonged and sometimes permanent.1 …

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    Footnotes

    • Contributors AS (main author)—conceived the idea of the digital care pathway—did service design and implementation of the system—did the main authoring work on this paper; MR, (second author)—coordinated the medical foundational work on the digital care pathway—contributed secondarily to authoring the paper. Other contributors to the paper (stated in the Acknowledgements section), who did medical foundational work on the digital care pathway, and also reviewing and commenting on the early draft of the paper: Trine Lilly Halvorsen, Jon Anders Halvorsen.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests Both authors work for the company Askin—a commercial teledermatology service in Norway that delivers the digital care pathway described in this research. All contributors to this research are employed by Askin. The corresponding author’s contributions to the digital care pathway are service design, development and implementation. The second author’s contributions to the digital care pathway are medical foundations and service design.

    • Provenance and peer review Not commissioned; externally peer reviewed.