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Optimizing the Dermatologic Formulary at a Free Clinic.

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Free clinics can optimize dermatology care by analyzing diagnoses and medication use. This study led to adding triamcinolone ointment and suggesting alternatives for ketoconazole shampoo, improving medication access for underserved patients.

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Area of Science:

  • Dermatology
  • Health Services Research
  • Pharmacology

Background:

  • Free clinics are vital for underserved populations, offering specialized care like dermatology.
  • Medication optimization and formulary management in free clinics remain understudied.
  • The Birmingham Free Clinic provides dermatology services and has an onsite dispensary.

Purpose of the Study:

  • To analyze dermatologic diagnoses and medication distribution patterns.
  • To optimize the dermatologic formulary at a free clinic.
  • To improve medication access for patients receiving specialty care.

Main Methods:

  • Retrospective chart review of dermatology clinic visits from January 2020 to May 2022.
  • Descriptive statistical analysis of diagnoses and prescribed medications.
  • Evaluation of onsite medication availability and distribution patterns.

Main Results:

  • Dermatitis, psoriasis, acne/rosacea, alopecia, and infections were the most common diagnoses.
  • Triamcinolone cream/ointment, doxycycline, ketoconazole shampoo, and hydrocortisone cream were frequently prescribed.
  • 52% of medications were dispensed onsite, with triamcinolone ointment and ketoconazole shampoo often unavailable.

Conclusions:

  • Formulary adjustments included adding triamcinolone 0.1% ointment and suggesting alternatives for ketoconazole 2% shampoo.
  • This study offers a model for optimizing specialty care formularies in free clinic settings.
  • Improved formulary management can enhance medication access for vulnerable patient populations.