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There has been an increase in formularies/guidelines suggesting the use of ointments and creams for dry skin or eczema. Bath additives are less likely to be advocated.
As per the findings of a 2021 cross-sectional study published in “Clinical and Experimental Dermatology”, there has been a notable increase in the total number of exclusive recommended leave-on emollients. Notably, a shift was observed, with most Clinical Commissioning Groups (CCGs) no longer endorsing the use of bath emollients for eczema. Nana Yaa T Amakye investigated the landscape of emollient prescribing formularies and guidelines across CCGs in England as of 2021.
Emollients play a crucial role in managing dry skin conditions, and prescribers typically adhere to local National Health Service (NHS) formularies in the UK. Building on a previous 2018 study that highlighted wide variations in recommended emollients across England and Wales, the present research emphasized the evolving consensus that bath additives offer no added clinical advantage in eczema.
The primary objective of the study was to compare emollient formularies and guidelines across England. The study investigators recognized and examined 105 CCGs, of which 72 were emollient formularies and 47 were emollient prescribing guidelines. Significantly, discrepancies within formularies and their accompanying guidelines were identified in 19% of cases.
The majority (68%) of formularies/guidelines employed a ranking system for organizations, revealing additional nuances in prescribing practices. The investigation recognized overall 126 distinct leave-on emollients, these were creams and ointments being widely accessible first-line suggested options. Interestingly, cost considerations were more predominant than patient choice as a criterion for choosing the suitable emollient.
Among the specific emollients, aqueous cream arose as the most frequently not recommended leave-on emollient. Also, 74% of formularies discouraged bath additive prescriptions due to limited clinical effectiveness. While all CCGs in England maintain an emollient formulary or guideline, significant variability exists in their recommendations, as concluded.
Clinical and Experimental Dermatology
Emollient prescribing formularies and guidelines in England, 2021: a cross-sectional study
Nana Yaa T Amakye et al.
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