Physicians' perceptions of the impact of the reclassification of vaginal antifungal agents

In January 1991, miconazole and clotrimazole were released as nonprescription therapy for vaginal candidiasis. Considering the number of women suffering from vaginal symptoms annually, these new over-the-counter (OTC) products may have a considerable impact on women's health care.

All 191 family physicians and obstetrician and gynecologist members of the Toledo and Lucas County Academy of Medicine were surveyed in June 1992. The survey instrument was constructed to include questions regarding physician perceptions of the impact of OTC antifungal agents on preventive care; the type of advice they currently give patients concerning the use of OTC antifungal agents; and their estimates of the incidence of misdiagnosis and reported side effects resulting from use of OTC antifungal agents.

Of the surveyed physicians, 24% concluded that the reclassification of antifungal agents was a positive change for their female patients, 19% believed it was a negative change, and the remaining 57% noted no impact on their patients' well-being. Over 40% of the physicians indicated that four to six of their patients had delayed treatment for other vaginal conditions because of inappropriate use of an OTC antifungal preparation within the last year. On a positive note, the physicians in favor of the OTC preparations believed their patients were getting faster and more economical care and were in "control of their health care."

Physicians participating in this study reported mixed opinions concerning the reclassification of vaginal antifungal agents and raised several pertinent questions that require further examination.