Prescription and application adequacy of topical corticosteroids based on the finger-tip unit method in adult patients with atopic dermatitis: A cross-sectional study.

Background: Atopic dermatitis is a chronic inflammatory skin condition treated with topical corticosteroids as first-line therapy. The Finger-Tip Unit (FTU) serves as an objective indicator for determining appropriate amounts of topical corticosteroids. However, the amount of topical corticosteroids prescribed and the amount actually applied by patients based on the FTU method in clinical practice and its efficiency remain unclear. Methods: We conducted a cross-sectional study at 36 community pharmacies in Japan. Atopic dermatitis patients aged ≥16 years prescribed topical corticosteroids were surveyed. The primary outcome was FTU-based prescription insufficiency, defined as an insufficient amount of prescription compared to the required application amount based on the FTU method. Secondary outcomes included FTU-based application insufficiency, defined as an insufficient amount of application compared to the required application amount based on the FTU method, and patient-reported prescription insufficiency. We also explored factors associated with FTU-based application insufficiency. Results: Among 116 participants, FTU-based prescription insufficiency was observed in 35.7% of patients. FTU-based application insufficiency and patient-reported prescription insufficiency were observed in 39.8% and 17.4% of patients, respectively. Moreover, FTU-based prescription insufficiency was associated with FTU-based application insufficiency (adjusted OR: 4.12, 95%CI: 1.72-9.87, Conclusions: In patients with atopic dermatitis, about one-third or more had insufficient corticosteroid prescriptions and applications based on FTUs. All healthcare providers, including primary care physicians, dermatologists, and pharmacists, may ensure prescription amounts and provide guidance on application doses that align with FTU methods.