Topical Corticosteroid Phobia among Parents of Children with Atopic Eczema in Korea

Abstract

BackgroundTopical corticosteroids (TCS) are the first-line agents for the treatment of atopic dermatitis (AD). However, a vague phobia concerning the use of TCS exists among parents of children with AD because of misinformation, and studies on the subject are insufficient.ObjectiveTo assess the current state of steroid phobia among parents of atopic children in Korea and to investigate the importance of education in its reduction.MethodsBy using a structured questionnaire, 126 parents of children with AD (22.2% fathers, 77.8% mothers) were interviewed. After the questionnaire administration, all participants were educated about TCS use.ResultsOverall, 67.5% of the parents showed steroid phobia. A statistical correlation was found between steroid phobia and knowledge of potential adverse events, experience of TCS use, and adherence to treatment (p<0.05). Adherence to treatment tended to be lower among parents with steroid phobia. The most recognized adverse effects of TCS were skin atrophy and thinning (71.9%). The most prevalent information source leading to steroid phobia was the Internet (49.2%). The risk factors for steroid phobia were AD severity (odds ratio [OR]=5.332 [moderate], 9.040 [severe] vs. mild; p=0.001) and the knowledge of potential adverse events (OR=2.658; p=0.021).ConclusionWe found a high prevalence of steroid phobia among parents of patients with AD, and here show the impact of this phobia on treatment adherence. We emphasize the important role of dermatologists as providers of accurate information and appropriate education about the use of TCS.

Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I

“…Patient fear of side‐effects of corticosteroids (corticophobia) is quite common and should be recognized and adequately addressed to improve adherence and avoid undertreatment …”

Corticosteroid phobia (corticophobia) in parents of young children with atopic dermatitis and their health care providers

“…Corticophobia among parents has a negative influence on the adherence to topical corticosteroids . It is important to provide parents with the correct information.…”

“…It is important to provide parents with the correct information. The sources from which patients receive information about corticosteroids include health care professionals, friends and relatives, broadcast media, print media, and the Internet, with the main source being health care professionals …”

“…It is important to investigate the factors influencing corticophobia to increase the adherence to topical corticosteroids. A substantial number of studies have assessed corticophobia in patients with atopic dermatitis or their parents and demonstrated that corticophobia is common and has a negative impact on adherence . However, no studies have addressed corticophobia in professionals involved in caring for children with atopic dermatitis.…”

Use of topical glucocorticoids: a population‐based cohort study

“…These events range from non‐dermatologic events such as hypothalamic–pituitary–adrenal axis suppression, Cushing syndrome, diabetes mellitus and cataracts to various cutaneous events such as cutaneous tinea, allergic contact dermatitis, perioral dermatitis and skin atrophy . The fear of these adverse events is frequently cited as a cause for topical glucocorticoid phobia and prescription non‐adherence . The risk of adverse events is related to characteristics of the prescription (e.g.…”