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Clinical Study: Incorporating a pre-consultation on-line isotretinoin video to acne patients

A clinical study by Dr Anthony MR Downs, DMC Healthcare Ltd & Dr Ian H Coulson Burnley General Teaching Hospital

YouTube® is the most popular internet-based search engine with a large body of educational Dermatology content. This information platform is more concerned with freedom of content rather than accuracy any of the scientific material.

In addition, unfiltered comments on YouTube® videos can be equally favourable or spiteful. Comments and videos can be deliberately misleading, designed for financial gain or champion bizarre alternative health beliefs.

Despite the unpredictability of YouTube® content it presents an opportunity to provide patients with additional information about their disease and treatment. That should improve adherence and facilitate informed consent.

Patients referred to our service with acne unresponsive to primary care treatment were sent a YouTube® link to www.youtube.com/watch?v=tlbZzqtgBvE.

At initial consultation, those patients that had viewed the video (irrespective whether isotretinoin was prescribed) and the clinician were asked to provide feedback on the video and the consultation.

A sample of 50 patients were reviewed. Age range 13 to 49 (mean of 21) of which 35 were female. Clinicians felt that the consultations were shorter (90%) and easier (90%). Isotretinoin was clinically indicated and started in 90% of patients. Only 5% of consultations took longer than normal.

Some patients felt an isotretinoin written information leaflet as well as the video were not necessary (40%) and face-to-face consultations completely necessary (100%). Of those that chose to be treated with isotretinoin, 95% confirmed the video helped in their decision and helped their consultation experience. Only one patient with a pre-existing anxiety state was worried by the video content.

This video offers an opportunity to offer an alternative information format to compliment the traditional consultation and written information. It shows photographs of treatment responses and side-effects that other written formats, do not.

We believe it helps prepare patients for the consultation by providing them with knowledge that allows for a faster and more constructive dialogue with the clinician.

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