P073 Integrating advanced pharmacist practitioners into isotretinoin care: improving clinical outcomes, patient experience and dermatology workforce productivity

Abstract

Dermatology services face a growing mismatch between workforce capacity and patient demand. Increasing referral volumes and prioritization of urgent and procedural care have reduced access for high-volume chronic conditions such as acne vulgaris. Isotretinoin remains the most effective therapy for severe acne but requires complex regulatory oversight, including iPLEDGE compliance, which further strains dermatology clinic workflows. The aim of this study was to evaluate the impact of an advanced pharmacist practitioner (APP)-led, dermatologist-supervised isotretinoin clinic on clinical outcomes, medication adherence, patient experience and dermatologist productivity. This mixed-methods evaluation assessed an internal medicine–dermatology isotretinoin clinic run jointly by APPs and a supervising dermatologist. A retrospective review included 67 patients managed between January 2023 and December 2025, with a focused isotretinoin cohort of 26 patients stratified by refill timing as a surrogate for adherence. APPs provided structured counselling, monthly follow-up, laboratory review, adverse-effect monitoring and iPLEDGE compliance, with dermatologist oversight as needed. Patient-reported outcomes were assessed using the 12-item Isotretinoin Pharmacist-Led Care Questionnaire (IPLC-Q-12), completed by 20 patients, evaluating education, regulatory navigation, adherence, clinical improvement and satisfaction. Dermatologist time savings and relative value unit (RVU) implications were estimated using standardized clinic workflow analyses. Pharmacist-led isotretinoin management was associated with high adherence, reduced treatment delays, and improved continuity of care. Patients with better refill adherence demonstrated greater acne severity reduction. Mean IPLC-Q-12 scores exceeded 4.1 out of 5 across all domains. No safety events were observed. APP involvement reduced direct dermatologist visits by approximately 40% and saved an estimated 20 min per patient receiving isotretinoin per month, translating to 62–78 RVUs per month. APP-led isotretinoin clinics improve clinical and patient-reported outcomes while delivering meaningful dermatologist time savings and productivity gains.