Oishi Nobuo, Iwata Hiroki, Kobayashi Noriko, Fujimoto Kazuko, Yamaura Katsunori
Division of Social Pharmacy, Center for Social Pharmacy and Pharmaceutical Care Sciences, Faculty of Pharmacy, Keio University.
Drug Discov Ther. 2019 Jul 22;13(3):128-132. doi: 10.5582/ddt.2019.01007. Epub 2019 Jun 14.
Atopic dermatitis (AD) is a common chronic, pruritic inflammatory skin condition. AD is most commonly treated with topical corticosteroids, and the finger-tip unit (FTU) should be used as a guideline for the amount to be used per application. In this study, we investigated the adequacy of pharmacists' instructions on the amount of topical steroids to be applied and the way in which they enhance the effect of pharmaceutical interventions. A self- administered anonymous questionnaire was distributed using QLifePro to 300 pharmacists working in insurance pharmacies that filled at least one dermatologist's prescription per month on average in Japan. Out of 300 pharmacists, 196 (65.3%) recognized the Japanese Dermatological Association's 2016 guidelines for the treatment AD, 107 (35.6%) gave instructions using the FTU as an index of external dose of topical steroids, 157 (52.3%) explained the amount of steroid application using an index other than FTU, and 61 (38.9% of 157) had inadequately instructed AD patients to apply steroids as a thin layer. Pharmacists who had read the guidelines for AD tended to give an appropriate instruction using FTU as an index of external dose of topical steroids (p < 0.001). We found that many pharmacists in pharmacies gave inadequate instructions on the amount of topical steroid application and deviated from the guidelines for AD, mainly because of inadequate knowledge of the guidelines.
特应性皮炎（AD）是一种常见的慢性瘙痒性炎症性皮肤病。AD最常用局部糖皮质激素治疗，指尖单位（FTU）应用作每次用药量的指导标准。在本研究中，我们调查了药剂师关于局部用类固醇用药量的指导是否充分，以及他们增强药物干预效果的方式。使用QLifePro向日本平均每月至少填写一张皮肤科医生处方的保险药店工作的300名药剂师发放了一份自行填写的匿名问卷。在300名药剂师中，196名（65.3%）认可日本皮肤病协会2016年AD治疗指南，107名（35.6%）以FTU作为局部用类固醇外用剂量指标进行指导，157名（52.3%）使用FTU以外的指标解释类固醇用药量，其中61名（占157名的38.9%）对AD患者使用类固醇薄涂的指导不充分。阅读过AD指南的药剂师倾向于以FTU作为局部用类固醇外用剂量指标进行适当指导（p<0.001）。我们发现，药店中的许多药剂师对局部用类固醇用药量的指导不充分，且偏离了AD指南，主要原因是对指南的了解不足。
