ABSTRACT
<b>Objective: </b>Finger-tip unit (FTU) has been used in Western countries to apply a specific amount of steroid ointment available in tube form. Although prescription ointments for treating skin disorders are available in Japan, there are no indications for patients regarding the amount to be used. Therefore, we investigated the factual assessment of patient compliance instructions on using the ointments given by pharmacists and conducted a comparative test on the amount of ointment in 1 FTU using commercially available ointment tube products.<br><b>Methods: </b>We conducted a questionnaire survey for 21 hospital pharmacists on patient compliance instructions for ointments. Using six types of ointments, we measured the aperture area of ointment tube, weight of 1 FTU and squeezing number of tube.<br><b>Results: </b>Fewer than 50% of pharmacists explained the application methods and amounts for one-time use when they provided patient compliance instructions. There were many patients who used an ointment inadequately. The most were problems about the quantity of application. Wide variations were found among the amount of ointment in 1 FTU weight and number of available uses.<br><b>Conclusion: </b>The survey results demonstrated that the methods used to apply the ointments are items that must also be emphasized by pharmacists when providing patients compliance instructions. Furthermore, the patient compliance instructions should include the amount of ointment in 1 FTU and number of available uses within pharmaceutical products.
ABSTRACT
BACKGROUND: Dermatologic patients need advice on how much ointment or cream to apply, in particular topical corticosteroids. The instructions given to patients concerning topical therapy are frequently vague. OBJECTIVE: The aims of this study are to make simple guidelines on the topical application of ointments or creams for patients, parents, doctors and nurses, and to check the accuracy of these guidelines in practice. METHODS: The average height and weight according to the different age groups and sex were measured from Korean standard growth and developement chart. From this chart, their total body surface areas(BSA) were calculated using a standard nomogram. The length of the tips of their index fingers was measured; measuring from the distal skin-crease to the end of the finger. One finger-tip unit(FTU) was defined as the amount of ointment expressed from a tube nozzle with a 5 mm in diameter, covering from the distal skin-crease to the tip of the palmar aspect of the index finger. The average area of abdominal skin covered by one finger-tip unit, and that of one palm were measured by computer scanner(Hurapack scanner, 4C) and image analyzed program(Image Pro. Plus(R) V. 3.0, Micromedical). Each patient then placed his or her right hand lightly, palm side down with the fingers and thumb closed, onto Hurapack scanner 4C. A tracing of the outer edge of the hand was made from the ulnar to radial styloid by photoshop program. The outlined area and enclosed area were measured by an image analyzer. RESULTS: 1. The average length of each finger-tip was 2.48+/-0.2cm in males and 2.24+/-0.13cm in females. 2. The average weight of one FTU was 0.46+/-0.03g in males and 0.40+/-0.02g in females. 3. The average area of palm was 145+/-12.4cm2 in males and 115.9+/-10.1cm2 in females. 4. The average area of abdominal skin covered by one FTU was 278+/-34.4cm2; The average area was 303+/-24.3cm2 in males and 253+/-21.9cm2 in females. 5. The number of FTU of adult male required to treat various anatomical sites was : face and neck, 2.6; trunk and buttock, 10.5; arm and hand, 5; leg and foot, 10. The number of FTU of adult female was : face and neck, 2.8; trunk and buttock, 11; arm and hand, 5.5; leg and foot 11. 6. The number of FTU of children required to treat each anatomical site was variable because of differential growth according to different age. CONCLUSION: The concept of FTU provides convenient means of rapidly assessing the approximate amount of ointment or cream required for the treatment of patients.