AN OPD BASED PROSPECTIVE EXPLORATORY STUDY OF DERMATOPHYTOSIS - FOCUS ON TREATMENT OUTCOMES, MEDICATION ADHERENCE, AND QUALITY OF LIFE
Keywords:Dermatophytosis, 5D-itch, Quality of life, Medication adherence, Treatment outcome, DLQI, Effectiveness
Objective: The study was planned primarily to judge the effectiveness, safety, and adherence of the prescribed treatments in dermatophytosis along with the effect on the Quality of Life (QoL) of the affected individuals.
Methods: In this prospective observational study, spanning over 5 months, participants (dermatophytosis patients) were assessed at baseline and 6 week-follow-up at study site. Information about their clinical presentation, QoL (Quality of Life) parameters, medication adherence, and adverse drug reaction (ADR) were entered in the Case Report Form (CRF) prepared by utilizing global standard tools such as 5D-itch scale, Dermatology Life Quality Index (DLQI), Medication Adherence Rating Scale (MARS), and WHO-ADR reporting form respectively.
Results: Total 60 subjects (33 males and 27 females) had completed the study. Overall, tinea cruris (40%) was the most common variety followed by combination of tinea corporis and cruris (35%), tinea corporis (20%), and tinea incognito (3%). Pruritus was the predominant symptom. There was a significant (p<0.001) improvement of both 5D-itch & DLQI scores from baseline to follow-up stage (after 6 weeks). Treatment regimens were well tolerated (only eight subjects reported any adverse event such as gastric irritation and sedation). Medication adherence to the prescribed treatment was good; (mean MARS score 7.588±1.82). Mostly prescribed regimen was a combination of antifungal (oral plus topical) and antihistamine tablet (58/60, 96.66%). The most common drug combination was capsule itraconazole, luliconazole cream, and cetirizine or levocetirizine tablet with or without ketoconazole soap (35/60, 58.33%).
Conclusion: Prescribed treatment regimen for dermatophytosis was effective, tolerable, acceptable with high medication adherence and also improved the QoL of the study subjects.
Sahoo AK, Mahajan R. Management of Tinea corporis, Tinea cruris, and Tinea pedis:A comprehensive review. Indian Dermatol Online J 2016;7:77-86.
Das S, De A, Saha R, Sharma N, Khemka M, Singh S, et al. The current Indian epidemic of dermatophytosis:A study on causative agents and sensitivity patterns. Indian J Dermatol 2020;65:118-22.
Gandhi S, Patil S, Patil S, Badad A. Clinicoepidemiological study of dermatophyte infections in pediatric age group at a tertiary hospital in Karnataka. Indian J Paediatr Dermatol 2019;20:52-6.
Noronha TM, Tophakhane RS, Nadiger S. Clinico-microbiological study of dermatophytosis in a tertiary care hospital in North Karnataka. Indian Dermatol Online J 2016;7:264-71.
Dogra S, Uprety S. The menace of chronic and recurrent dermatophytosis in India: Is the problem deeper than we perceive? Indian Dermatol Online J 2016;7:73-6.
Rajashekar TS, Nandigonnanavar S, Kuppuswamy SK, Madhavi GS. Dermatology life quality index in patients with persisting and recurrent dermatophytosis. Int J Res Dermatol 2019;5:139-43.
Elman S, Hynan LS, Gabriel V, Mayo MJ. The 5‐D itch scale:A new measure of pruritus. Br J Dermatol 2010;162:587-93.
Brown S. Likert Scale Examples for Surveys. Iowa State University, USA: ANR Program Evaluation; 2010. Available from: https://www. jordankmportal.com/resources/likert-scale-examples-for-surveys. [Last accessed on 2021 Apr 25].
Finlay AY, Khan G. Dermatology life quality index (DLQI) a simple practical measure for routine clinical use. Clin Exp Dermatol 1994;19:210-6.
Standard format of Suspected Adverse Drug Reaction Reporting Form for Voluntary Reporting of Adverse Drug Reactions by Healthcare Professionals; 2020. Available from: http://www.ipc.nic.inor;http:// www.cdsco.nic.in/pharmacovigilance.htm. [Last accessed on 2021 Apr 25].
Thompson K, Kulkarni J, Sergejew AA. Reliability and validity of a new medication adherence rating scale (MARS) for the psychoses. Schizophr Res 2000;42:241-7.
Lakshmanan A, Ganeshkumar P, Mohan SR, Hemamalini M, Madhavan R. Epidemiological and clinical pattern of dermatomycoses in rural India. Indian J Med Microbiol 2015;33 Suppl:134-6.
Patro N, Panda M, Jena AK. The menace of superficial dermatophytosis on the quality of life of patients attending referral hospital in Eastern India:A cross-sectional observational study. Indian Dermatol Online J 2019;10:262.
Thomas J, Saple DG, Jerajani HR, Netha NR, Rangasamy DU, Shaikh R, et al. Real-world, non-interventional, observational study of hydroxyzine hydrochloride in chronic pruritus:A prospective, non-comparative study. Dermatol Ther (Heidelb) 2019;9:299-308.
Tsunemi Y, Abe S, Kobayashi M, Kitami Y, Onozuka D, Hagihara A, et al. Adherence to oral and topical medication in 445 patients with tinea pedis as assessed by the Morisky medication adherence scale-8. Eur J Dermatol 2015;25:570-7.
Elewski B, Tavakkol A. Safety and tolerability of oral antifungal agents in the treatment of fungal nail disease:A proven reality.Ther Clin Risk Manag 2005;1:299-306.
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