|
• White Paper (5)
• Pseudoephedrine (2)
• Eczema
• Chemotherapy
• Community pharmacy (2)
• Locum pharmacy
• Packaging
• Dispensing
• MDS
• Parallel imports
• Prescription charges
• The Society
• Skill mix
• Professionalism
• Boots travel insurance
Letters to the Editor
|
Eczema
Patient and carer knowledge of skin preparations
From Dr R. Woodford, MRPharmS
Increasing attention is being paid by health care professionals and parents
to the management of childhood eczema, and the investigation
by Alison Carr and colleagues (PJ, 17 March, pp319–22) is timely and exciting.
With a variety of bath additives, shower gels, emollient creams and ointments
augmented by topical steroids of differing potencies, a wide range of preparations
is available. Perhaps it is not too surprising that parents may have unwarranted
concerns and a poor understanding of the correct use of dermatological
products.
Woodford et al1 found that the parents of 26 children (aged five years
or under) who used hydrocortisone cream scored highest on both knowledge
of preparation and potential side effects of topical steroids, but exhibited
the greatest “steroid phobia” in a study of 203 patients and
carers in 10 age brackets that were prescribed corticosteroids. These parents
also had little apparent knowledge of the relative value of moisturisers
or steroids in the management of their child’s eczema. In most cases,
the intended mode of emollient application was questionable (insufficient
quantity, infrequent application, concomitant use of hydrocortisone cream).
An unpublished 18-month audit conducted in the same pharmacy of persons
seeking advice on their skin condition was presented 10 years ago to the
Primary Care Dermatology Society.2 Of the 714 initial consultations, 26
per cent were diagnosed as eczema or dermatitis and 15 per cent were dry
skin conditions. Of the 2,782 prescriptions for dermatological preparations
dispensed during that audit period, 31 per cent were for emollients. Elements
of that work were accepted as evidence in the 2000 “Report on the
enquiry into skin diseases in elderly people” published by the Associate
Parliamentary Group on Skin. With an aging population suffering dry skin
and with the continuing misery of childhood eczema, the use of skin moisturisers
is set to increase. Continuing education for patients and their carers
regarding the use of several preparations in “complete emollient
therapy” is an important role for pharmacists and confusion regarding
the use of “wash-off” and “leave-on” emollients
may well exist. Dr Carr and the community pharmacists involved in her study
are to be congratulated on their conscientious approach. Their paper deserves
a wide readership.
Roger Woodford
Portsmouth
References
1. Woodford R, Woodford EM, Langley CA, Marriott JF, Wilson KA. Patient
knowledge and acceptability of topical corticosteroid preparations: the
role of the pharmacist in patient education. International Journal of
Pharmacy Practice 2001;9(Suppl):R38 (PDF 40K)
2. Woodford R. Responding to patients and their symptoms in a village
community pharmacy — dermatological presentations. Paper presented at the Primary
care Dermatology Society Annual Meeting, Harrogate, 1997. |
The
Pharmaceutical Journal