PURPOSE OF THE STUDY.
To study fear of topical corticosteroid use among patients with atopic dermatitis (AD) by looking at adherence to treatment regimens and the association with beliefs and attitudes.
Subjects were French patients with AD who were seen in hospital outpatient dermatology departments or dermatology private practices, between February and May 2009.
This was a prospective, multicenter study where a 69-item questionnaire was created after interviews with patients (n = 21) and health professionals (n = 15). It was then administered to patients with AD who were seen as consults of the outpatient dermatology clinics of university hospitals (n = 5) and from private dermatology practices (n = 53). Univariate and multivariate analyses were performed.
A total of 208 questionnaires were analyzed (including 144 from parents and 87 from adult patients, 27 of whom were also parents). Fears about topical steroids were reported in 80.7%, and nonadherence was reported in 36% of respondents. Correlations were found between topical steroid phobia and a need for reassurance, the belief that topical corticosteroids pass through the skin into the bloodstream, prior adverse events, inconsistent information about the quantity of cream to apply, a desire to self-treat for the shortest time possible, and poor treatment adherence. There was no correlation between topical steroid phobia and AD severity.
Topical steroid phobia is a real and complicated issue. It is common among patients with AD and has an impact on adherence with topical steroids.
Topical steroids are key medications used in the treatment of AD. Many treatment failures for AD are likely caused by a lack of adherence due to topical steroid phobia. This study is important as it hammers home the need to address concerns about topic steroid side effects and to provide clear and consistent directions for administration. The authors suggest that verbal and supplemental information be given on AD, treatment regimens, and their side effects.
- Copyright © 2012 by the American Academy of Pediatrics