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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.
Insights
UK primary care broadly follows onychomycosis treatment guidelines. Oral terbinafine and topical amorolfine are common prescriptions, with variations observed in drug choice based on patient gender and age.
Area of Science:
- Dermatology
- Pharmacology
- Public Health
Background:
- Onychomycosis treatment literature focuses on optimal strategies, yet real-world primary care practices remain under-documented.
- Understanding primary care treatment patterns is crucial for assessing guideline adherence and identifying treatment disparities.
- This study addresses the gap in knowledge regarding actual onychomycosis management in UK primary care settings.
Purpose of the Study:
- To delineate the treatment patterns for onychomycosis within UK primary care.
- To analyze treatment variations based on patient demographics, specifically gender and age.
Main Methods:
- A retrospective, population-based, cross-sectional study design was employed.
- The Health Improvement Network (THIN) database was utilized for data extraction from 2001-2017.
- Incidence rates and prescription data for oral and topical antifungal treatments were analyzed.
Main Results:
- An onychomycosis incidence rate of approximately 50 per 100,000 individuals was recorded.
- Treatment was more prevalent in males (52%) than females (48%) and in the 50-59 age group.
- Oral terbinafine and topical amorolfine were the most frequently prescribed antifungals, with gender-based prescribing differences noted.
Conclusions:
- Primary care treatment of onychomycosis in the UK demonstrates general adherence to national treatment guidelines.
- Observed prescribing patterns suggest a concordance between recommended and actual clinical practice.
- Further analysis could explore reasons for gender-specific drug preferences.
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