Racial, ethnic, and biologic sex disparities in outpatient laboratory monitoring of isotretinoin use: a cross-sectional study.
Journal
International journal of dermatology
ISSN: 1365-4632
Titre abrégé: Int J Dermatol
Pays: England
ID NLM: 0243704
Informations de publication
Date de publication:
Apr 2024
Apr 2024
Historique:
received:
05
09
2023
accepted:
27
11
2023
pubmed:
18
12
2023
medline:
18
12
2023
entrez:
18
12
2023
Statut:
ppublish
Résumé
Isotretinoin is commonly used for the treatment of acne. Despite high efficacy, isotretinoin has a side effect profile that prompts regular outpatient laboratory monitoring. Emerging evidence suggests clinically significant lab abnormalities are rare. Racial, ethnic, and biologic sex disparities in laboratory monitoring of isotretinoin have yet to be characterized. This study explores disparities in laboratory monitoring of patients prescribed isotretinoin, factoring in the COVID-19 pandemic given its impacts on laboratory monitoring. Two populations were evaluated: all patients taking isotretinoin, and patients taking isotretinoin with no metabolic, cardiovascular, hematologic, hepatic, or renal comorbidities. The latter population was included to screen out patients who might receive increased laboratory testing for conditions besides isotretinoin use. Our data reveal that African-American, Asian, and Hispanic patients prescribed isotretinoin were more likely than Caucasian patients to receive orders for outpatient laboratory monitoring. These disparities persisted independent of comorbidities that may prompt additional testing, suggesting that non-Caucasian patients bear an additional testing burden even when their comorbidities were matched to their peers. Disparities persisted in the setting of reduced laboratory monitoring due to the COVID-19 pandemic. These data reveal that patients of color are more likely to receive outpatient laboratory monitoring for isotretinoin prescriptions. There is an opportunity for testing standardization to improve medication access, decrease burden and costs for patients and the healthcare system, and decrease racial disparities in prescribing and monitoring of isotretinoin. Dermatology clinics may benefit from standard operating procedures outlining for whom regular monitoring is needed.
Sections du résumé
BACKGROUND
BACKGROUND
Isotretinoin is commonly used for the treatment of acne. Despite high efficacy, isotretinoin has a side effect profile that prompts regular outpatient laboratory monitoring. Emerging evidence suggests clinically significant lab abnormalities are rare. Racial, ethnic, and biologic sex disparities in laboratory monitoring of isotretinoin have yet to be characterized.
METHODS
METHODS
This study explores disparities in laboratory monitoring of patients prescribed isotretinoin, factoring in the COVID-19 pandemic given its impacts on laboratory monitoring. Two populations were evaluated: all patients taking isotretinoin, and patients taking isotretinoin with no metabolic, cardiovascular, hematologic, hepatic, or renal comorbidities. The latter population was included to screen out patients who might receive increased laboratory testing for conditions besides isotretinoin use.
RESULTS
RESULTS
Our data reveal that African-American, Asian, and Hispanic patients prescribed isotretinoin were more likely than Caucasian patients to receive orders for outpatient laboratory monitoring. These disparities persisted independent of comorbidities that may prompt additional testing, suggesting that non-Caucasian patients bear an additional testing burden even when their comorbidities were matched to their peers. Disparities persisted in the setting of reduced laboratory monitoring due to the COVID-19 pandemic.
CONCLUSIONS
CONCLUSIONS
These data reveal that patients of color are more likely to receive outpatient laboratory monitoring for isotretinoin prescriptions. There is an opportunity for testing standardization to improve medication access, decrease burden and costs for patients and the healthcare system, and decrease racial disparities in prescribing and monitoring of isotretinoin. Dermatology clinics may benefit from standard operating procedures outlining for whom regular monitoring is needed.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
481-483Informations de copyright
© 2023 the International Society of Dermatology.
Références
Lee YH, Scharnitz TP, Muscat J, Chen A, Gupta‐Elera G, Kirby JS. Laboratory monitoring during isotretinoin therapy for acne: a systematic review and meta‐analysis. JAMA Dermatol. 2016;152(1):35–44.
Barbieri JS, Shin DB, Wang S, Margolis DJ, Takeshita J. The clinical utility of laboratory monitoring during isotretinoin therapy for acne and changes to monitoring practices over time. J Am Acad Dermatol. 2020;82(1):72–79.
Rogers AT, Semenov YR, Kwatra SG, Okoye GA. Racial disparities in the management of acne: evidence from the National Ambulatory Medical Care Survey, 2005–2014. J Dermatolog Treat. 2018;29(3):287–289.
Barbieri JS, Shin DB, Wang S, Margolis DJ, Takeshita J. Association of race/ethnicity and sex with differences in health care use and treatment for acne. JAMA Dermatol. 2020;156(3):312–319.