Exton L S, Cheung S T, Brain A G, Mohd Mustapa M F, de Berker D A R
British Association of Dermatologists, London, UK.
Dermatology Department, Cannock Chase Hospital, Cannock, Staffordshire, UK.
Clin Exp Dermatol. 2017 Jun;42(4):381-389. doi: 10.1111/ced.13068. Epub 2017 Feb 20.
In 2010, the British Association of Dermatologists (BAD) published clinical guidelines for the safe introduction and continued use of isotretinoin in patients with acne in the UK. The BAD provides UK dermatologists with a facility for national audit, and it undertook an audit on compliance with these guidelines in 2012.
To determine current clinical practices relating to use of isotretinoin among dermatologists in the UK (including geographical variations) as measured against BAD standards, and to ascertain any improvement since the 2012 audit.
The 2012 isotretinoin audit proforma was used, with additional questions on clinical setting, complaints and litigation. A web-based survey tool was used for data entry and submission, with email invitation to working, UK-based BAD members (n = 1226) in December 2013 and weekly reminders during the 8.5-week data collection period. Responders were requested to enter data for the three most recent consecutive patients (including one male and one female patient) who had completed treatment within the previous 6 months.
In total, 338 (27.6%) respondents provided data on 1013 patients. Serum lipids were checked in 93.4% of patients and documentation of mental health and/or mood state was recorded in 82.1%. Regarding the Pregnancy Prevention Programme (PPP), 91.6% of female patients of childbearing potential had signed the PPP information form, while 93.3% who had followed the PPP had taken pregnancy tests both before and during treatment, and 54.7% had taken a pregnancy test 5 weeks post-treatment.
Overall, there is currently good compliance with standards. Certain aspects of care that are less frequently preformed, such as pregnancy testing post-treatment, are highlighted.
2010年，英国皮肤科医师协会（BAD）发布了关于在英国痤疮患者中安全引入和持续使用异维甲酸的临床指南。BAD为英国皮肤科医生提供了全国性审计工具，并于2012年对这些指南的遵守情况进行了审计。
根据BAD标准，确定英国皮肤科医生使用异维甲酸的当前临床实践（包括地域差异），并确定自2012年审计以来是否有任何改进。
使用2012年异维甲酸审计表格，并增加了关于临床环境、投诉和诉讼的问题。使用基于网络的调查工具进行数据录入和提交，于2013年12月通过电子邮件邀请在职的英国BAD成员（n = 1226）参与，并在为期8.5周的数据收集期间每周发送提醒。要求受访者输入前6个月内完成治疗的最近连续3例患者（包括1例男性和1例女性患者）的数据。
共有338名（27.6%）受访者提供了1013例患者的数据。93.4%的患者进行了血脂检查，82.1%记录了心理健康和/或情绪状态。关于预防妊娠计划（PPP），91.6%有生育潜力的女性患者签署了PPP信息表，93.3%遵循PPP的患者在治疗前和治疗期间都进行了妊娠试验，54.7%在治疗后5周进行了妊娠试验。
总体而言，目前对标准的遵守情况良好。强调了一些较少执行的护理方面，如治疗后妊娠试验。
