GPs' perspectives on acne management in primary care: a qualitative interview study

Area of Science:

• Dermatology
• General Practice
• Qualitative Research

Background:

• Acne vulgaris is a prevalent skin condition affecting a majority of adolescents.
• Current guidelines advocate for topical treatments as first-line therapy for acne.
• However, prolonged courses of oral antibiotics are frequently prescribed in clinical practice.

Purpose of the Study:

• To investigate the perspectives of general practitioners (GPs) on the management of acne vulgaris.
• To understand the factors influencing treatment choices between topical and oral therapies for acne.

Main Methods:

• A qualitative interview study was conducted with general practitioners (GPs) in South West England.
• Purposive sampling ensured a diverse range of participants.
• Semi-structured telephone interviews were analyzed using inductive thematic analysis.

Main Results:

• GPs reported uncertainties regarding topical acne treatments, including product selection, side effects, and patient acceptability.
• Many GPs perceived topical treatments as less effective than oral antibiotics or felt patient pressure to prescribe oral medications.
• Familiarity with oral antibiotics and limited concern for antimicrobial stewardship in acne management were noted. Some GPs were unaware of or disregarded guidelines on antibiotic duration.

Conclusions:

• General practitioners exhibit uncertainty in utilizing topical acne treatments, often perceiving them as less effective.
• Patient-related factors and perceived pressure contribute to the preference for oral antibiotics over topical therapies.
• There is a need to address GP uncertainties and patient expectations to improve adherence to acne management guidelines and promote antimicrobial stewardship.