Isotretinoin (more commonly known as Accutane) is an oral drug that is used to treat the most severe forms of acne. The medication belongs to a class of drugs called retinoid which are analogues of vitamin A. The efficacy of isotretinoin is unquestionable—patients’ skin clears dramatically with a 5-6 month course of treatment, which is often permanent. Isotretinoin is considered by some to be the “cure” for acne. Unfortunately, the miracle drug causes many side effects, some of which are severe. Isotretinoin is a strong “teratogen,” or drug that, when taken by a pregnant patient, can cause severe birth defects in the fetus. The drug has been associated with fetal malformations such as skull abnormalities and brain defects, spontaneous abortion, and premature birth. Isotretinoin has also been associated with psychiatric disorders such as depression, psychosis and suicide. Other more common, less serious side effects include dry skin, itchiness, nosebleeds, dry mouth and conjunctivitis.
What is iPledge?
In order to ensure patients are informed about isotretinoin’s serious risks and safe-use conditions, the Food and Drug Administration (FDA) created iPLEDGE. iPLEDGE is a program that strictly regulates the prescribing and monitoring of isotretinoin. Doctors, patients, and pharmacists must all actively participate in the program when a patient is taking the drug.
While the goals of iPLEDGE are certainly worthy and warranted, the program requires doctors and patients to endure an exorbitant amount of paperwork, lab testing, and tedious tasks to prescribe isotretinoin. Doctors must effectively counsel their patients on the risks of isotretinoin, and then prove that they have done so in order to register their patients on iPLEDGE. Patients must then wait to receive an ID card through the mail in order to register online. Then the patient must also complete a series of online tasks and quizzes to prove that they understand the risks of isotretinoin. Patients who are women of childbearing age must take a pregnancy test for two consecutive months with negative results in order to begin taking isotretinoin. Isotretinoin is only dispensed by certain approved pharmacies. Once they have started taking the medication, patients must complete monthly lab tests in order to receive their next month of medication from their dermatologist.
And to top it off, iPLEDGE is an unclear, poorly developed platform that seems to always cause problems among users. Doctors end up wasting valuable time dealing with administrative issues and answering confused patients’ questions. Patients end up waiting an excessive amount of time to begin the medication. The result of this process is often confusion and frustration by both the doctor and patient.
So how can you make sure your patients are getting their medication and appropriate monitoring, without getting bogged down by iPLEDGE?
Better doctor-patient communication!
How To Make iPledge Easier For Patients?
Klara, the HIPAA compliant online platform for doctor-patient communication, has many tools and features that can cut down the time you spend dealing with iPLEDGE in half.
Keep an open line of communication. Reduce those frustrated patient phone calls by giving your patients easy access to your office staff. With Klara’s secure and easy to use interface, patients can send your practice quick questions about iPLEDGE which your office staff can answer in a snap. Patients are satisfied and you can spend more time seeing patients.
Use templates to send patients instructions that they can reference whenever. Let’s face it, iPLEDGE confuses even the smartest patient. Explaining the process one time in the office is not enough. With Klara, you can create templates of detailed instructions to patients with a click of a button. Patients then always have access to the document through Klara online. Never explain the same thing twice.
Send reminders about upcoming next steps. When taking isotretinoin, patients need to complete frequent lab tests, dermatology appointments, medication refills, and online tasks. If they forget even one step, their medication can be denied. With Klara, you can send reminders to keep patients focused and avoid those frantic phone calls from the pharmacy.
Labs, labs, labs. Patients taking isotretinoin need monthly lab tests to make sure they are healthy. Spare your patients unnecessary trips to the office by using Klara to report normal lab results. Your patients will have peace of mind and you will have more open appointment times.
Keep tabs on those side effects. While most required monitoring of patients on isotretinoin concerns the rare, serious side effects, most patients have common side effects that are easily resolved (such as dry skin, itching, etc.). On Klara, you can anticipate these common patient complaints by using our questionnaires feature. Create and automatically send questionnaires to patients asking if they are experiencing common side effects. Based on their responses, your office staff can reply with templates explaining easy over-the-counter remedies. That way you can spend your time seeing patients with more urgent conditions.
While the FDA and American Academy of Dermatology work together to improve iPLEDGE, you can keep your practice afloat by using Klara.