Table 2 Responses of general practitioners regarding not prescribing Isotretinoin in their practice
Question | Response | Frequency (%); N = 223 |
|---|---|---|
Why would you not prescribe Isotretinoin? | Not being aware that GPs have permission to prescribe it | 58 (74) |
Worries regarding liver dysfunction | 122 (54.7) | |
Worries regarding its teratogenicity | 83 (37.2) | |
Lack of knowledge of the drug | 70 (31.4) | |
Worries regarding abnormal lipid profile | 46 (20.6) | |
I am not interested | 47 (21.1) | |
Being wary of the legal complaints | 37 (16.6) | |
No coverage by insurance companies | 23 (10.3) | |
Worries regarding mucocutaneous dryness | 22 (9.9) | |
Worries regarding workload | 10 (4.5) | |
Being wary of suicidality | 8 (3.6) | |
Not having relevant patients | 8 (3.2) | |
I believe only dermatologists should prescribe it | 10 (3.1) | |
There was no need for my patients to start Isotretinoin | 7(2.8) | |
Not having accurate follow-up | 2 (0.8) | |
Drug side effects | 2 (0.8) | |
Not in my experience field | 1 (0.4) | |
Are you interested in prescribing Isotretinoin in your future primary care visits? | No | 114 (51.1) |
Yes | 109 (48.9) | |
What would persuade you to prescribe Isotretinoin? | Guideline from health care systems | 111 (49.8) |
Complementary educations | 103 (46.2) | |
The guidance of a dermatologist, if needed | 103 (46.2) | |
Proper support from the Food and Drug Administration (FDA) and forensic medicine | 67 (30) | |
Financial aid | 16 (7.2) | |
Proper follow-up | 2 (0.8) | |
Proper knowledge of the drug | 1 (0.4) | |
Higher efficacy compared to other drugs of choice | 1 (0.4) | |
Patient’s request | 1 (0.4) | |
Indication for starting Isotretinoin | 1 (0.4) | |
None of the above | 30 (13.4) | |
Do you believe that Isotretinoin should only be administered by a specialist? | Yes | 122 (54.7) |
No | 101 (45.3) | |
In your opinion, what are the requirements for GPs who prescribe Isotretinoin? | Complementary education in Dermatology | 105 (47.1) |
Previous experience in working under a dermatologist supervision | 82 (36.8) | |
being a member of dermatology associations | 21 (9.4) | |
Interest in the dermatology field | 18 (8.1) | |
Being aware of the drug information (indication, blood tests, and follow-up) | 7 (2.8) | |
Obeying the guideline | 1 (0.4) | |
Insufficient education in this regard | 1 (0.4) | |
No response in first-line treatment options | 1 (0.4) | |
None of the above | 76 (34) | |
Are you aware that Isotretinoin is being prescribed in primary care centers? | Yes | 109 (48.9) |
No | 114 (51.1) | |
Do you believe that primary care settings can prescribe Isotretinoin safely? | Yes | 105 (47.1) |
No | 118 (52.9) | |
Do you believe there are safety measures in the primary care setting for prescribing Isotretinoin? | Yes | 134 (60.1) |
No | 89 (39.9) | |
Would it be beneficial if Isotretinoin were used vastly in primary care settings? | Yes | 107 (48) |
No | 116 (52) | |
Would the specialists support Isotretinoin usage in primary care settings? | Yes | 55 (24.7) |
No | 168 (75.3) |