Table 1 Responses of general practitioners who prescribe Isotretinoin toward their management and practice

In the past year (2020), how many patients did you prescribe Isotretinoin for?

0–10

77 (90.6)

10–50

6 (7.1)

50–100

2 (2.4)

More than 100

0

What are your main reasons for starting Isotretinoin in a primary care setting?

Interest in treating patients with dermatologic disorders

51 (60)

The long wait for dermatologist visits

13 (15.3)

Experience in working in an aesthetic medicine clinic

8 (9.4)

No response to prior treatments

5 (6.0)

Financial incentive

3 (3.5)

Indication for resistant nodulocystic acne

1 (1.2)

According to my previous experiences, I prescribe for those with severe acne

1 (1.2)

None of the above

16 (18.8)

What did you prescribe Isotretinoin for?

Moderate to severe acne

53 (62.4)

Nodulocystic acne

46 (54.1)

No response to oral antibiotics

41 (48.2)

Patient’s request

19 (22.4)

Acne accompanied by an ulcer

5 (5.9)

Psychologic complications due to having acne

1 (1.2)

Which gender group would you prescribe Isotretinoin for?

Females

22 (25.9)

Males

7 (8.2)

Both

56 (65.9)

What are the reasons you refuse to prescribe Isotretinoin?

Labs indicating liver failure

79 (92.9)

Untrustworthy contraceptive methods

61 (71.8)

Alcoholism

45 (52.9)

Central nervous system disorders

29 (34.1)

Current depression

23 (27.1)

Previous history of depression

12 (14.1)

Abnormal lipid profile

4 (4.8)

Pregnancy and fertile groups

1 (1.2)

How would you decide on Isotretinoin dosage?

Based on weight

40 (47.1)

General starting dose

39 (45.9)

Based on acne severity

34 (40.0)

Based on gender

4 (4.7)

At what intervals would you visit female patients?

Every month

52 (61.2)

Every two months

12 (14.1)

Every three months

12 (14.1)

Only the first session

4 (4.7)

None of the above

4 (4.7)

With intervals of more than three months

1 (1.2)

At what intervals would you visit male patients?

Every month

41 (48.2)

Every two months

15 (17.6)

Every three months

13 (15.3)

Only the first session

4 (4.7)

With intervals of more than three months

4 (4.7)

None of the above

4 (4.7)

In what intervals would you request pregnancy tests?

Each month before prescription

44 (51.8)

Only the first session

21 (24.7)

With intervals of more than a month

12 (14.1)

Never

6 (7.1)

In the case of pregnancy, I would not prescribe

1 (1.2)

I have not had a female patient before

1 (1.2)

What methods would you choose for contraception?

Barrier contraception

43 (50.6)

Oral contraceptive drugs (OCP)

24 (28.2)

Both intra-uterine devices (IUD) and OCP

21 (24.7)

Long-term contraceptive methods like progesterone injections or IUD

14 (16.5)

I would not prescribe anything

12 (14.1)

None of the above

6 (7.1)

Would you refer patients with a previous history of depression to a specialist before starting Isotretinoin?

No

33 (38.8)

Yes

22 (25.9)

If there is a possibility of having depression, I would not prescribe Isotretinoin

20 (23.5)

It depends on the patient

10 (11.8)

Would you request blood tests before starting Isotretinoin?

Yes

79 (92.9)

No

6 (7.1)

What type of blood tests would you request?

Liver function tests

79 (92.9)

Lipid profile

57 (67.1)

Complete blood count

57 (67.1)

Fasting blood sugar

36 (42.4)

Thyroid function tests

28 (32.9)

After starting treatment, at what interval would you request blood tests?

Every month

31 (36.5)

Once after 6–8 weeks

7 (8.2)

Every two months

14 (16.5)

Every three months

16 (18.8)

Intervals of more than three months

8 (9.4)

None of the above

1 (1.2)

One month after, then every two months

1 (1.2)

For how long would you prescribe Isotretinoin in each visit?

Less than a month

11 (12.9)

One to three months

30 (35.3)

Three to six months

35 (41.2)

Six to nine months

3 (3.5)

Nine to twelve months

4 (4.7)

More than twelve months

2 (2.4)