What can GP data tell us about the treatment of onychomycosis in the UK?

BACKGROUND

Treatment of onychomycosis is challenging, and there is much literature on optimal treatment strategies. In contrast, information on how onychomycosis is actually treated in primary care is scarce. Information on practice is important as it can reveal much, such as, to what extent national guidelines are followed and which population groups seek/receive treatment or do not do so.

OBJECTIVES

To describe the pattern of onychomycosis treatment in primary care in the UK, by patient's gender and age.

METHODS

A population-based retrospective cross-sectional study was conducted. The Health Improvement Network (THIN) database was used to calculate incidence rates of onychomycosis in the years 2001-2017. The prescription of oral and topical anti-fungal drugs to patients with onychomycosis was reviewed.

RESULTS

THIN data showed an onychomycosis incidence rate of about 50 per 100,000. More males than females (52% vs. 48%), and more people aged 50-59 years had received treatment for onychomycosis. Oral terbinafine was the most commonly prescribed drug, followed by topical amorolfine, although terbinafine was used more commonly by men and amorolfine by women. Patients with onychomycosis were also prescribed other antifungals, including itraconazole, griseofulvin, tioconazole, ketoconazole shampoo, fluconazole and clotrimazole. A greater proportion of women, compared to men, were prescribed fluconazole.

CONCLUSIONS

Onychomycosis treatment in primary care in the UK is broadly in concordance with national guidelines.