Topical corticosteroid concerns from the clinicians’ perspective

Mueller, Simon M.; Tomaschett, Dominique; Vogt, Deborah R; Itin, Peter; Cozzio, Antonio; Surber, Christian

doi:10.1080/09546634.2016.1255307

Cited by 17 publications

(10 citation statements)

References 30 publications

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“…10,11 Rates of AEs and discontinuations due to TEAEs in this study were greatest in the first 12 weeks of HP/TAZ treatment and decreased over time; AE rates were lowest after 36 weeks of treatment, with individual TEAEs reported in two or fewer participants. Survey data indicate that concerns about AEs from TCS use are common among both patients and clinicians, 20,21 and contribute to non-adherence in up to 28% of patients. 20 As the study population after week 12 was enriched for participants that had achieved IGA score improvement, these decreasing AE rates over time suggest that treatment with HP/TAZ lotion may minimize safety concerns for patients, potentially contributing to improved long-term adherence.…”

Section: Discussionmentioning

confidence: 99%

Long‐term safety and efficacy of a fixed‐combination halobetasol propionate 0.01%/tazarotene 0.045% lotion in moderate‐to‐severe plaque psoriasis: phase 3 open‐label study

Lebwohl

Gold

Papp

et al. 2021

Acad Dermatol Venereol

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Background The topical corticosteroid halobetasol propionate (HP) and the retinoid tazarotene (TAZ) are effective in psoriasis treatment. To mitigate adverse cutaneous reactions observed with monotherapy, a fixedcombination HP 0.01%/TAZ 0.045% lotion has been developed for the treatment of plaque psoriasis in adults.Objectives To investigate the long-term safety, efficacy and maintenance of response with HP/TAZ lotion. Methods This was a 1-year, multicentre, open-label study in 555 adults with psoriasis [Investigator's Global Assessment (IGA) score of 3 ('moderate') or 4 ('severe') and body surface area (BSA) of 3-12% at baseline]. HP/TAZ was administered once daily for 8 weeks and then intermittently as needed in 4-week intervals for up to 1 year based on achievement of treatment success [IGA score of 0 ('clear') or 1 ('almost clear')]. Maximum continuous exposure was 24 weeks.Results Of 550 participants with postbaseline safety data, 318 (57.8%) achieved treatment success during the study.Of those, 54.4% achieved treatment success within the first 8 weeks; retreatment was not required for >4 weeks in over half (55.3%), and 6.6% did not require any retreatment. Among participants enrolled for the full 52 weeks, 77.5% maintained BSA ≤5% on treatment. There were marked improvements in severity of itching, dryness and burning/stinging over the study course. The most common treatment-related adverse events were application site reactions of dermatitis, pruritus, pain and irritation. Conclusions Fixed-combination HP/TAZ lotion provided maintained efficacy with a favourable tolerability and safety profile, supporting its use for the long-term treatment and management of moderate-to-severe plaque psoriasis.

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Section: Discussionmentioning

confidence: 99%

Long‐term safety and efficacy of a fixed‐combination halobetasol propionate 0.01%/tazarotene 0.045% lotion in moderate‐to‐severe plaque psoriasis: phase 3 open‐label study

Lebwohl

Gold

Papp

et al. 2021

Acad Dermatol Venereol

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“…10,12,16 These differences are due in part to variability in professionals' TCS knowledge as well as the professionals' own fears regarding the potential adverse effects of these treatments. 10,14,17,18 Patients are looking for information, [19][20][21][22][23][24][25][26][27][28] particularly about adverse effects. [29][30][31][32][33] However, studies have shown that physicians provide little information regarding pharmacological treatments.…”

Section: Introductionmentioning

confidence: 99%

Optimizing Communication About Topical Corticosteroids: A Quality Improvement Study

et al. 2020

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Background Patients are often non-adherent to topical corticosteroids (TCS). This may be in part due to poor communication between patients and dermatologists. Objectives This quality improvement (QI) study aims to describe dermatologist–patient communication about TCS treatments and to compare communication before and after the implementation of an educational intervention. Methods This QI study assesses the communication between dermatologists and new dermatology outpatients receiving a TCS prescription in a tertiary care center. The QI intervention is 2-pronged, consisting of an educational pamphlet for patients and a communication workshop for the dermatology team. Encounters were audiotaped, and communication was analyzed using a coding system (MEDICODE). Phase 1 recordings happened preintervention and reflect the usual dermatologist–patient communication in this practice setting and phase 2 recordings were postintervention. Results Phase 1 reveals that dermatologists frequently address informational medication themes, such as naming the medications and informing patients about their proper use. They less frequently discuss patient experience themes, such as goals of treatment, adverse effects of treatments, and exploring patients’ emotions about medications (such as anxiety, fears, etc.). After the intervention, there was more frequent discussion of patient experience themes without increasing consultation length. But, in both phases, physicians address most themes as a monolog with little verbal input from patients. Conclusions Our study raises awareness regarding dermatologists’ communication patterns about TCS, identifying specific areas for improvement, such as discussions of adverse effects, and explicitly addressing patients’ attitudes and emotions. This is an essential step to foster a sense-making of TCS for patients.

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“…TCS phobia has been shown to improve with patients' education [7]. Physicians (non-dermatologists) have concerns about using TCS more than dermatologists [8]. Additionally, pharmacists (from France and Australia) have low levels of confidence regarding the use of TCS [9,10].…”

Section: Introductionmentioning

confidence: 99%

Family Medicine Trainees’ Knowledge about Topical Corticosteroids in Jeddah, Saudi Arabia

Kokandi¹

2019

TODJ

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Background: Topical corticosteroids (TCS) are used to treat a variety of dermatological conditions. The fear of side effects sometimes affects the adherence to treatment. The aim of this study was to assess the knowledge and the attitude of family medicine residents under training for the use of TCS. Methods: Family medicine trainees attending an educational session were surveyed via live electronic questionnaires. Results: A total of 89 (out of 100 who attended the event) people responded to the questionnaire. Undergraduate teaching was the main source of information about TCS. Most of the respondents advised the use of TCS sparingly or using finger-tip unit amount. More than half of them thought TCS can be absorbed and it should not be used to some body areas such as eyelids. Majority of the respondents did not think that TCS use can lead to infections, weight gain or obesity, damage the skin if used for a few weeks, negatively affect health or lead to asthma. More than 40% thought that it is better to stop TCS treatment as soon as possible in atopic dermatitis patients. Conclusion: Family medicine trainees have some fears and misconceptions regarding TCS use. There is a need to increase the knowledge about TCS in undergraduate and postgraduate teaching.

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Topical corticosteroid concerns from the clinicians’ perspective

Abstract: The majority of clinicians may have inaccurate knowledge of certain aspects of TCC and own concerns to use TCS.

Cited by 17 publications

References 30 publications

Long‐term safety and efficacy of a fixed‐combination halobetasol propionate 0.01%/tazarotene 0.045% lotion in moderate‐to‐severe plaque psoriasis: phase 3 open‐label study

Long‐term safety and efficacy of a fixed‐combination halobetasol propionate 0.01%/tazarotene 0.045% lotion in moderate‐to‐severe plaque psoriasis: phase 3 open‐label study

Optimizing Communication About Topical Corticosteroids: A Quality Improvement Study

Family Medicine Trainees’ Knowledge about Topical Corticosteroids in Jeddah, Saudi Arabia

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