Abstract
BackgroundAcne vulgaris, a common skin disease, affects up to 80 % of the population. Moderate to severe acne requires treatment with a combination of topical and oral drugs such as antibiotics, hormones and retinoids. Retinoids have many contraindications and adverse effects requiring close monitoring. The study’s objectives were to describe prescribing trends in acne medication over time in a military setting, and assess physician adherence to guidelines for acne treatment, including drug precautions, clinical monitoring, and treatment progression.MethodsWe conducted a descriptive, serial cross-sectional study of acne drugs prescribed in the Israel Defense Forces (IDF) in the years 2002–2007, analyzing the classes of drugs prescribed and patient characteristics. In addition, the clinical quality of the medical encounter was assessed by examining physician adherence to IDF guidelines.ResultsBetween 2002 and 2007, 64,281 patients were treated for acne. Treatment courses generally persisted for 1–2 months. Over 70 % of female patients receiving oral retinoids were not concomitantly receiving oral contraceptives.ConclusionThis study provides a unique perspective of acne treatment in a military setting, overall displaying good adherence to general guidelines. The common prescription of oral retinoids to young females without concomitant contraception is alarming.
Highlights
Acne vulgaris, a common skin disease, affects up to 80 % of the population
The Israel Defense Forces (IDF) pharmacy management program was queried for all acne medications as defined in Appendix and cross referenced with the patient records arising from the computerized patient record (CPR) database, creating a record of acne therapy composed of prescribing and dispensing encounters for the same patients
Over the study period, we identified 159,316 encounters with acne recorded as the diagnosis, representing 64,281 individual patients
Summary
A common skin disease, affects up to 80 % of the population. Moderate to severe acne requires treatment with a combination of topical and oral drugs such as antibiotics, hormones and retinoids. Acne vulgaris is a common inflammatory skin disease with a complex and multifactorial pathogenesis. Acne commonly appears on the face, but may be found on the upper chest, shoulders and back [2]. It can result in severe cosmetic blemishing and can be emotionally distressing to affected individuals, especially to adolescents and young adults [4]. Acne vulgaris affects over 80 % of the population at some stage in life, especially young adults. A gradual increase in the age of onset has been observed and in over 8 % of patients the onset is after the age of 25, more commonly in women [11]
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