Dermatologists' Adherence to the Latest Recommendations for Screening of Hydroxychloroquine Retinopathy in Saudi Arabia: Cross-Sectional Study
Date Submitted: Jun 27, 2019
Open Peer Review Period: Jul 2, 2019 - Aug 27, 2019
Background: Hydroxychloroquine (HCQ) has been used to manage many inflammatory skin conditions. Nevertheless, retinopathy remains its most significant adverse effect. The American Academy of Ophthalmology (AAO) recommends baseline ophthalmologic screening in the first year of HCQ treatment. However, a recent study found an inadequate awareness of the recommendations. Furthermore, limited data are available regarding the implementation of the recommendations among dermatologists. Objective: The purpose of this study was to assess dermatologists’ adherence to recommendations pertaining to their current practice regarding HCQ toxicity detection. Methods: A self-administrated questionnaire was distributed between February 2, 2018, to May 4, 2018 among members of the Saudi Society of Dermatology. The questionnaire was designed by Shulman et al. Consisted of demographics-related questions and questions pertaining to each physician’s routine practice about the follow-up of HCQ-treated patients. Results: A total of 76 dermatologists completed the questionnaire. We achieved a response rate of 62.54%. More than half (43 [56.6%]) were male. Furthermore, more than half (41 [53.9%]) reported treating 1-3 patients with HCQ during the last year.Furthermore, two-thirds (47 [61.8%]) reported screening patients before initiating HCQ treatment. Regarding follow-up recommendations, 45 (59.2%) reported “yearly after starting treatment” for no-risk patients, while 72 (94.7%) reported “yearly within 5 years of treatment” for at-risk patients. Data were considered significant at P < 0.05. All analysis was performed by using SPSS, version 20 (IBM, Armonk, NY, USA). Conclusions: Saudi dermatologists are not well informed about some aspects of the latest recommendations regarding screening for HCQ toxicity in terms of tests, follow-up timing, cessation of the drug, and causative agents. Therefore, we recommend conducting more studies in Saudi Arabia to determine the adherence of more physicians to the AAO recommendations. Furthermore, patient education regarding HCQ toxicity and increasing patient awareness is recommended for effective and safe HCQ use.