The effects of topical steroid fears and concerns on patients with eczema: first TOPICOP© scale-based study in Saudi Arabia
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20210472Keywords:
Eczema, Atopic eczema, Topical corticosteroids, Fears, Steroid phobia, Concerns, TOPICOP© scaleAbstract
Background: Topical corticosteroids (TCS) are the main treatment for eczema, which are often required for months (or years) to control the disease. Despite the well-known side effects of TCS, their efficacy and safety are well established when used appropriately. This study was conducted to assess the fears, concerns, and various practices of patients with eczema toward TCS in the Qassim region of Saudi Arabia.
Methods: A cross-sectional survey-based study was conducted that targeted patients with eczema among all age groups and genders attending the dermatology outpatient clinics. There were no exclusions based on the type, severity, or duration of the disease.
Results: A total of 105 patients with eczema were recruited for this study. It was revealed that 46.8% of participants stopped their treatment as soon as possible, which indicates immediate discontinuation of steroids after their eczema flares had subsided and improved. An interesting finding was that 38.3% of participants did not start their TCS treatment until the disease deteriorated rather than when flare-ups occurred.
Conclusions: Exaggerated fears about TCS exist among patients with eczema and their care givers. This can result in non-adherence or wasting of many prescribed TCS preparations TCS. It is very important to understand and emphasize on the nature and extent of the prevalence of TCS fears to ensure that prompt, correct advice can be offered. Since dermatologists remain the most trusted source of information, there should be an emphasis on individual patient counseling and increased engagement in social media with pre-planned content.
Metrics
References
Williams HC, Burney PG, Pembroke AC, Hay J. The U.K. Working Party’s Diagnostic Criteria for Atopic Dermatitis. III. Independent hospital validation. Br J Dermatol. 1994;131:406-16.
Williams H, Robertson C, Stewart A, Aït-Khaled N, Anabwani G, Anderson, R et al. Worldwide variations in the prevalence of symptoms of atopic eczema in the International Study of Asthma and Allergies in Childhood. J Allergy Clin Immunol. 1999;103:125-38.
Foley P, Zuo Y, Plunkett A, Marks R. The frequency of common skin conditions in preschool-age children in Australia: atopic dermatitis. Arch Dermatol. 2001;137:293-300.
Barbeau M, Bpharm HL. Burden of atopic dermatitis in Canada. Int J Dermatol. 2006;45:31-6.
Lawson V, Lewis-Jones MS, Finlay AY, Reid P, Owens RG et al. The family impact of childhood atopic dermatitis: The Dermatitis Family Impact Questionnaire. Br J Dermatol. 1998;138:107-13.
Hoare C, Li Wan Po A, Williams H. Systematic review of treatments for atopic eczema. Health Technol Assess. 2000;4:1-191.
Furue M, Terao H, Rikihisa W, Urabe K, Kinukawa N, Nose Y et al. Clinical dose and adverse effects of topical steroids in daily management of atopic dermatitis. Br J Dermatol. 2003;148:128-33.
Hon KL, Tsang YC, Pong NH, Luk DC, Lee VW, Woo WM et al. Correlations among steroid fear, acceptability, usage frequency, quality of life and disease severity in childhood eczema. J Dermatolo Treat. 2015;26(5):418-25.
Krejci-Manwaring J, Tusa MG, Carroll C, Camacho F, Kaur M, Carr D et al. Stealth monitoring of adherence to topical medication: adherence is very poor in children with atopic dermatitis. J Am Acad Dermatol. 2007;56:211-16.
World Health Organization. Adherence to Long-term Therapies: Evidence for Action. Geneva: WHO. 2003.
Charman CR, Morris AD, Williams HC. Topical corticosteroid phobia in patients with atopic eczema. Bri j dermatol. 2000;142(5):931-6.
Li AW, Yin ES, Antaya RJ. Topical corticosteroid phobia in atopic dermatitis: a systematic review. JAMA Dermatol. 2017;153:1036-42.
Moret L, Anthoine E, Aubert-Wastiaux H. TOPICOP©: a new scale evaluating topical corticosteroid phobia among atopic dermatitis outpatients and their parents. PLoS One. 2013;8:e76493.
Stalder JF, Aubert H, Anthoine E, Futamura M, Marcoux D, Morren MA et al. Topical corticosteroid phobia in atopic dermatitis: international feasibility study of the TOPICOP score. Allergy. 2017;72:1713-9.
Moawad S, Mahé E, Aubert-Wastiaux H, Phan A, Maruani A, Chiaverini C et al. Topical corticosteroid concerns among parents of children with psoriasis versus atopic dermatitis: a French multicenter cross-sectional study. Am J Clin Dermatol. 2018;19:261-5.
Smith SD, Farrugia LL, Harris V. Evaluation of the influence of family and friends, and the Internet on patient perceptions of long-term topical corticosteroid use. J Dermatol Treat. 2017;28:642-6.
Smith SD, Lee A, Blaszczynski A, Fischer G. Pharmacists’ knowledge about use of topical corticosteroids in atopic dermatitis: pre- and post-continuing professional development education. Australas J Dermatol. 2016;57:199-204.
Farrugia LL, Lee A, Fischer G, et al. Evaluation of the influence of pharmacists and GPs on patient perceptions of long-term topical corticosteroid use. J Dermatol Treat. 2017;28:112-8.
Song SY, Jung SY, Kim EY. Steroid phobia among general users of topical steroids: a cross-sectional nationwide survey. J Dermatol Treat. 2018;30(3):245-50.
Tofte SJ, Hanifin JM. Current management and therapy of atopic dermatitis. J Am Acad Dermatol. 2001;44(1):13-6.
Li Y. Awareness of and phobias about topical corticosteroids in parents of infants with eczema in Hangzhou, China. Wiley Online Library. 2018;35(4):463-7.
Beck LA, Boguniewicz M, Hata T, Schneider LC, Hanifin J, Gallo R et al. Phenotype of atopic dermatitis subjects with history of eczema herpeticum. J Allergy Clin Immunol. 2009;124:260-9.
Choi E, Chandran NS, Tan C. Corticosteroid phobia: a questionnaire study using TOPICOP score. Singapore Med J. 2020;61(3):149-53.
Downloads
Published
How to Cite
Issue
Section
