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Clinical pharmacy and clinical trials (including case series)
The degree of patient satisfaction with diltiazem gel in the treatment of anal fissures
  1. M. Lobo Alves,
  2. N. Ribeiro,
  3. S. Alves,
  4. C. Neves,
  5. F. Falcão
  1. 1Hospital S. Francisco Xavier Pharmacy Lisbon, Portugal
  2. 2Hospital S. Francisco Xavier, Surgery, Lisbon, Portugal


Background Anal fissure is a common and painful condition that often affects young adults of both sexes. Topical 2% diltiazem gel is described as an effective first-line treatment for chronic fissure with an optimised toxicity profile. When it became unavailable on the Portuguese market, our hospital and the Faculty of Pharmacy from Lisbon University developed a formulation and are producing and dispensing it.

Purpose To assess the degree of patient satisfaction with the use of diltiazem gel in anal fissure.

Materials and methods Cross-sectional descriptive study with information collected at a single moment in time through a telephone interview.

Results All patients to whom the Pharmacy Department dispensed diltiazem gel between January and July 2011 were included. Number of patients was 137 (68 females, 69 males); mean age: 50.3 years. 70 patients answered the questionnaire (52 were excluded). The majority had higher education (baccalaureate or a degree). Regarding health status evolution, pain improved or improved considerably in 77% of patients. With regard to bleeding, it improved a lot or completely in 63% patients. As for itching and/or perianal irritation, it improved or improved considerably in 41% patients (33% didn't know). As for passing faeces, in 14% patients it greatly improved or improved completely (77% didn't know). Concerning side effects, only 2 patients had headaches and 1 mentioned dizziness. In terms of degree of satisfaction with the gel, 17% were completely satisfied, 57% very satisfied, 17% at least somewhat satisfied, 4% somewhat satisfied, 1% completely unsatisfied and 3% didn't know. Of the 70 patients, 56% considered themselves cured, not cured 39% and 6% didn't know.

Conclusions Diltiazem gel seems to be a good alternative for treating anal fissure. The production of medicines by pharmacy departments is very important for meeting patients' needs not met by the pharmaceutical industry.

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