Havet Anaïs, Moskal Aurélie, Payet Cécile, Massardier Jérôme, Lebrun-Vignes Bénédicte, Jonville-Béra Anne-Pierre, Chanelière Marc, Viprey Marie
Laboratoire Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France.
Hospices Civils de Lyon, Service des Données de Santé, Lyon, France.
Dermatol Ther (Heidelb). 2025 Jun;15(6):1533-1541. doi: 10.1007/s13555-025-01409-y. Epub 2025 Apr 18.
The coronavirus disease 2019 (COVID-19) pandemic disrupted care organization in France, likely changing the use of oral isotretinoin and worsening noncompliance with recommendations. We described the number of dispensations of isotretinoin, use of teleconsultation, and noncompliance with recommendations, before and during the COVID period.
This nationwide cohort included all subjects with isotretinoin dispensation between 2019 and 2022, using data from the French Health Data System (SNDS). The pre-COVID period corresponded to 2019, and the COVID period to 2020, 2021, and 2022. The first lockdown took place between March and May 2020. We calculated the relative change in the number of total and first dispensations and the difference in the percentage of teleconsultation and noncompliance with recommendations, including treatment initiation by dermatology specialists, prescription renewal, and pregnancy testing (PT), for each month, using 2019 as the reference. PT compliance was assessed in women aged 11-50 years.
A total of 2,020,624 dispensations were identified between 2019 and 2022, including 18.1% of first dispensations. Compared with the pre-COVID period, the number of total dispensations decreased (April 2020: -12.6%; May 2020: -9.7%), as did the number of first dispensations (March 2020: -18.3%; April 2020: -37.6%). Nevertheless, the number of total and first dispensations increased over the other months. The teleconsultation rate was close to 0 in the pre-COVID period and increased by 21.8% in April 2020. Noncompliance with treatment initiations by dermatologists increased throughout the COVID period compared with the pre-COVID period (mean: 2.2%; range: -0.5% to 5.5%). Noncompliance with prescription renewal and PT increased during the first lockdown (April 2020: 8.9% and 9.5%, respectively), and tended to stabilize thereafter.
The effect of the COVID-19 pandemic on isotretinoin use was mainly observed during the first lockdown. This study also highlights persistent noncompliance and the need to assess the new French communication actions.
2019年冠状病毒病（COVID-19）大流行扰乱了法国的医疗组织，可能改变了口服异维A酸的使用情况，并加剧了对相关建议的不依从性。我们描述了COVID期间前后异维A酸的配药数量、远程会诊的使用情况以及对建议的不依从性。
这项全国性队列研究纳入了2019年至2022年间所有接受异维A酸配药的受试者，数据来自法国卫生数据系统（SNDS）。COVID之前的时期对应2019年，COVID时期对应2020年、2021年和2022年。首次封锁发生在2020年3月至5月之间。我们以2019年为参照，计算了每月总配药数量和首次配药数量的相对变化，以及远程会诊百分比和对建议不依从性的差异，包括皮肤科专科医生开始治疗、处方续签和妊娠试验（PT）。对11至50岁女性的PT依从性进行了评估。
2019年至2022年间共识别出2,020,624次配药，其中18.1%为首次配药。与COVID之前的时期相比，总配药数量减少（2020年4月：-12.6%；2020年5月：-9.7%），首次配药数量也减少（2020年3月：-18.3%；2020年4月：-37.6%）。然而，在其他月份总配药数量和首次配药数量有所增加。COVID之前的时期远程会诊率接近0，2020年4月增加了21.8%。与COVID之前的时期相比，在整个COVID期间，皮肤科医生开始治疗的不依从性增加（平均：2.2%；范围：-0.5%至5.5%）。在首次封锁期间，处方续签和PT的不依从性增加（2020年4月分别为8.9%和9.5%），此后趋于稳定。
COVID-19大流行对异维A酸使用的影响主要在首次封锁期间观察到。这项研究还突出了持续存在的不依从性以及评估法国新沟通行动的必要性。
