ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 145
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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GPs’ treatment of acne in Norway 2012–19: Increased
isotretinoin prescription but only initiated by 26% of GPs
Mrs Cathrine Stroem Christiansen, Louise Emilsson, Morten Lindbæk
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Department of General Practice, Institute of Health and Society at University of Oslo
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Background
Acne is a common disease among youths and young adults, mainly treated by general practitioners
(GPs). Isotretinoin prescription is not restricted to dermatologists in Norway, unlike most comparable
countries.
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Objectives
To describe acne treatment in Norway from 2012 to 2019, with a focus on prescription patterns, type
of treatment and the role of the GPs.
Methods
This observational study was performed by linking individual-level data from nationwide healthcare
registries (The Norwegian Prescription Database [NorPD], Statistics Norway [SSB], Control and
Payment of Reimbursement to Health Service Provider’s database [KUHR] and The Regular General
Practitioner [RGP] registry) in Norway from 2012 to 2019. We included patients from 12 to 39 years
of age who either had an acne diagnosis or a relevant medication (topical treatment, tetracyclines 50
defined daily doses [DDDs] or more, or isotretinoin) registered before the age of 40. We compared
yearly prescription rates and adherence to recommendations comparing GPs and dermatologists.
Results
In all, 302,273 patients were included (63% female). Of these patients, 280,922 received acne
treatment, where 80%, 36% and 20% received topical treatment, tetracyclines and isotretinoin,
respectively. Comparing patterns of acne treatment shows that the use of isotretinoin increased by
118% from 2012 to 2019, tetracyclines increased by 10% and topical treatment increased by 8%, as
measured in DDDs. Hence, overall prescribing of isotretinoin increased dramatically over the study
period and more GPs initiated this type of treatment. Still, only 26% of GPs ever initiated isotretinoin.
Adherence to the recommendation to always use systemic antibiotics together with topical treatment
was low (26% among GPs and 44% among dermatologists).
Conclusions
Isotretinoin treatment prescription increased among GPs. A large proportion of tetracycline treatments
were prescribed without co-occurring topical treatment. Whether or not GPs initiating isotretinoin
treatment is correlated with more adverse events or adherence to recommended patient surveillance
remains to be investigated.
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