[Questionnaire-based study on the key to the guidance to the patients with atopic dermatitis by pharmacist]

Atopic dermatitis is a condition with a chronic or recurrent course that requires continued treatment, meaning that patients must be provided with instructions that fit their lifestyle. Surveys of doctors and patients have revealed the importance of instructions on how to apply topical medication. Here we conducted a survey of the instructions provided by pharmacists, who play an important role in educating patients on how to apply topical medication.

Questionnaires were distributed to clinics and dispensing pharmacies in Shimane and Hiroshima prefectures. The questionnaire format comprised selecting each matter on which instructions are provided.

A total of 548 questionnaires (response rate, 13.8%) were collected and analyzed. Concerning topical steroids, the most frequently instructed item was "Explanation of application site"(86%), followed by "Explanation of number and timing of applications"(68%). Only 45% chose "Instruction to apply a small amount to avoid side effects." For tacrolimus ointment, "Explanation of tingling sensation"(as a side effect) was the most frequently selected item (52%), and "Instruction by using a brochure"(27.3%) was more commonly selected for tacrolimus ointment than for steroids and emollients. "Demonstrate the application method by means of actual application" was selected by few respondents for any topical medication. Regarding what they wanted from doctors, many respondents wrote in the section for their own comments that they would like a clear description of the method of use and dose and indications of the amount to be applied. Failure included times when patients failed to apply medication correctly due to inadequate instructions and an insufficient explanation of side effects.

Instructions vary among patients and professions, but good instructions lead to good results. Cross-tabulation showed that pharmacists who are aware of the guidelines of atopic dermatitis offer significantly more instructions in a range of areas, suggesting that the first important task is to spread awareness of these guidelines among them.