Community pharmacist's' knowledge and practice toward oral isotretinoin prescription: a systemic review

Background: Although oral isotretinoin capsules are widely dispensed in pharmacies due to their effectiveness in clearing acne, the legal, ethical and practice responsibilities of community pharmacist regarding this medicine have not been well evaluated. This systematic review of community pharmacist's role and professional practice toward oral isotretinoin is significant to help pharmacy regulators and educator's making decisions to improve therapy outcomes. Review methods: Eligible studies covering the period between 2009 and 2019 were identified by searching: Cochrane, PubMed and Google Scholar databases. Results: A total of 56 studies were reviewed. It showed that pharmacy professionals exhibited a very low level of medication knowledge and an unsatisfactory level of practice regarding isotretinoin. Most studies showed that women of childbearing age were unnecessarily exposed to isotretinoin. These results indicate poor compliance of community pharmacists with risk minimization programs such as pregnancy prevention program (PPP) in Europe and iPLEDGE in USA. Conclusion: Community pharmacists need additional education, training and awareness in the area of oral isotretinoin to evaluate its use and patient's eligibility especially for female patients of childbearing age. This review results are critical to pharmacy educators worldwide who are concerned in implementing and developing professional practice standards for community pharmacists regarding oral isotretinoin.