Background: Despite the wide range of available treatment modalities a delay between the first outbreak
of acne vulgaris and an effective treatment outcome is experienced by many patients.
Considering the growing incentives to improve patient satisfaction and quality of care while reducing
healthcare costs, insights into the structure, quality and accessibility of acne healthcare services
beyond guidelines are therefore needed.
Objective: To provide insights into the structure, quality and accessibility of acne healthcare services.
Methods: A qualitative study was conducted according to the principles of ‘situational analysis’. The
Dutch acne healthcare system was taken as an illustrative example. Twenty-four semi-structured interviews
were conducted among representatives of the 4 main Dutch professions providing acne care.
All interviews were audiotaped, transcribed verbatim and analyzed.
Results: Multiple facilitators and barriers emerged from the interviews. Identified facilitators were care
providers delivering personalized patient care and having a positive attitude toward formalized multidisciplinary
care delivery. A lack of streamlined referral pathways and standardization in acne severityassessment,
financial aspects and unfamiliarity with the content and added value of other acne care
professionals were identified as barriers. Further research is recommended to investigate how demedicalisation,
the gatekeepers role, and the impact of location and work setting influence the quality
of and accessibility to care.
Conclusions: Identified facilitators and barriers and an overall positive attitude of care providers
toward multidisciplinary care provision provides opportunities for the utilization of future guidelines
involving streamlined referral pathways and good working arrangements between all acne care providing