Prevalence and clinical impact of topical corticosteroid phobia among patients with chronic hand eczema – findings from the Danish Skin Cohort Journal of the American Academy of Dermatology
Description
ABSTRACT Background: Topical corticosteroid phobia is associated with poor treatment adherence and is common among patients with skin disease. Knowledge about corticosteroid phobia and treatment adherence among patients with chronic hand eczema (CHE) is limited. Objectives: Investigate patient-reported outcomes regarding topical corticosteroids (TCS), and their impact on treatment adherence in CHE patients. Methods: CHE patients from the Danish Skin Cohort answered a questionnaire including the Topical Corticosteroid Phobia (TOPICOP) scale and Medication Adherence Report Scale (MARS-5). Response rate was 69.2%. Results: Of 927 with CHE, 75.5% totally or almost agreed that TCS damage the skin, 48.9% totally or almost agreed that TCS would affect their future health and 36.3% reported some degree of fear of TCS even though they were unaware of any TCS-associated risks. Most patients (77.9%) always or often stop treatment as soon as possible while 54.8% always or often wait as long as possible before starting treatment. Overall, 38.8% reported that they had taken less medicine than prescribed and 54.0% had stopped treatment throughout a period. Treatment adherence decreased with increasing corticosteroid phobia (p=0.004). Limitations: TOPICOP has not been validated in CHE patients. Conclusions: Corticosteroid phobia is common among CHE patients and negatively associated with treatment adherence.