TITLE:
Patient Preferences in the Treatment of Vaginal Candidiasis
AUTHORS:
Mark G. Martens
KEYWORDS:
Candidiasis, Miconazole, Patient Preference, Vulvovaginal Yeast Infections
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.12,
October
15,
2018
ABSTRACT: Vulvovaginal
candidiasis (VVC) is one of the most frequent problems facing women and their
healthcare professionals (HCP). It is difficult for providers to understand the
prevalence of VVC because effective over the counter treatments (OTC),
are available. It is expected that there are a great many more episodes of VVC
in our patient population, as the frequency of self-treatment, success and satisfaction for those that use OTC products prior to seeing a
women’s health care provider is unknown. In this study; healthcare providers were
given OTC miconazole/tioconazole units for free distribution to patients for
whom they diagnosed VVC by exam in their offices. Surveys for both HCP and
patients were also distributed to determine the initial or recurrent nature of
their symptoms and their satisfaction with their treatments. 1265 OBGYNs and 1821
NP/CNM/PAs reported on over 19,000 patients
receiving a single complete treatment. Among HCPs, treatment efficacy was the primary
reason for recommending miconazole/tioconazole.
However, rapid onset of symptom relief, safety vs. fluconazole, patient preference
for the less messy ovule, avoidance with drugs metabolized by the liver, and
resistance to, or failure on, fluconazole were additional reasons noted for
topical preference. Overall, patient satisfaction (n = 317)
was high at 95%, with 97% of patients reporting that they would use miconazole
again. Importantly, 100% of first time sufferers (n = 95)
would use miconazole again. The few patients dissatisfied with miconazole (2%),
reported no symptom relief, burning after use, an “allergic
reaction”, pain from the applicator or a messy discharge. Most patients using the
external symptom relief products were satisfied with the external cream (93%)
and wipes (96%). Almost all patients reported their yeast infection was cured (91%) and
that they experienced quick symptom relief (94%), despite the prevalence of
recurrent vs first time VVA sufferers that presented to offices in this trial.
Most patients were cured and satisfied with their treatment, therefore
supporting the use of topical miconazole/tioconazole as first line therapy for vulvovaginal candidiasis patients
presenting to a healthcare office.