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How does topical corticosteroid phobia affect treatment adherence in patients with atopic dermatitis?

Topical corticosteroid phobia refers to the negative feelings and beliefs related to topical corticosteroids experienced by patients and their caregivers.

This phenomenon may be a major contributing factor in treatment failure in patients with atopic dermatitis, yet is sparsely described in literature.

A recent study systematically assessed the prevalence, origins and effect on treatment adherence of topical corticosteroid phobia in atopic dermatitis.

The research looked at 16 cross-sectional studies. It found that the prevalence of topical corticosteroid phobia ranged from 21 percent to 83.7 percent. There was significant variation in how phobia was defined, ranging from concern to irrational fear.

In the two studies that compared non-adherence between a phobia group and a non-phobia group, patients in both phobia groups were found to have a significantly higher rate of non-adherence (49.4 percent versus 14.1 percent and 29.3 percent versus 9.8 percent).

The sources from which patients received information about corticosteroids included physicians, friends and relatives, broadcast media, print media, and the internet.

The findings showed that topical corticosteroid phobia is a widespread and cross-cultural phenomenon, and the study’s authors suggested that recognition of the phobia may identify opportunities to increase treatment adherence.

Additional research, using standardised definitions and methods of assessment, is needed to better characterise this phenomenon and evaluate the efficacy of potential interventions.

Read more recent research on atopic dermatitis.

Source:
Alvin W. Li, Emily S. Yin, Richard J. Antaya. Topical Corticosteroid Phobia in Atopic Dermatitis: A Systematic Review. JAMA Dermatol. 2017;153(10):1036–1042. doi:10.1001/jamadermatol.2017.2437

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