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Patient Perspective on Medication Adherence in Topical Corticosteroid Use

Year 2025, Volume: 16 Issue: 2, 144 - 152, 18.08.2025
https://doi.org/10.22312/sdusbed.1467584

Abstract

Objective: Topical treatment compliance in dermatology is poor. Topical corticosteroids (TCS) are effective dermatological treatments. Patients experience concern, which impacts their adherence. This study aims to explore the factors affecting adherence from the time the drug is prescribed to the time the prescription is taken.

Materials and methods: This study was conducted by snowball sampling via the Internet. The data were analyzed with SPSS 25.0. The statistically significant p-val is p<0.05.

Results: 136 people participated in the study. More than 90% of them stated that the physician explained the medication use and that they used it as described, even if there were different recommendations. The score for being sure of understanding and retention was above eight on a 10-point scale. Giving 10 points to TCS concerns was observed in 20% of them. Physicians and pharmacists positively affect TCS adherence. Concerns about their child were higher in women, and anxiety was higher in those who used for their child and in those who used for both themselves and their child.

Discussion: There are a few problems in the physician and pharmacist process. However, patients may be exposed to misinformation at the pharmacy. This situation affects the fear of TCS. The participants' fear of TCS was reasonable. This fear increases in women in pediatric use and with age.

Conclusion: To prevent misinformation in the post-physician process, it may be beneficial to raise awareness of non-dermatologist sources, especially the pharmacy. Dermatologists, other physicians, and pharmacies.should work parallel within.

References

  • 1. Okwundu N, Cardwell LA, Cline AE, Richardson IM, Feldman SR. Adherence to topical treatment can improve treatment-resistant moderate psoriasis. Cutis. 2020;105(2):89-91;e2;e3.
  • 2. Krejci-Manwaring J, McCarty MA, Camacho F, Carroll CL, Johnson K, Manuel J, et al. Adherence with topical treatment is poor compared with adherence with oral agents: implications for effective clinical use of topical agents. J Am Acad Dermatol. 2006;54(5 Suppl):S235-6. doi:10.1016/j.jaad.2005.10.060.
  • 3. Alsubeeh NA, Alsharafi AA, Ahamed SS, Alajlan A. Treatment Adherence Among Patients with Five Dermatological Diseases and Four Treatment Types - a Cross-Sectional Study. Patient Prefer Adherence. 2019;13:2029-38. doi:10.2147/ppa.S230921.
  • 4. 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(2):211-6. doi:10.1016/j.jaad.2006.05.073.
  • 5. Morley KW, Dinulos JG. Update on topical glucocorticoid use in children. Curr Opin Pediatr. 2012;24(1):121-8. doi:10.1097/MOP.0b013e32834ef53d.
  • 6. Finnegan P, Murphy M, O'Connor C. #corticophobia: a review on online misinformation related to topical steroids. Clin Exp Dermatol. 2023;48(2):112-5. doi:10.1093/ced/llac019.
  • 7. Moreau E, Rousseau H, Marzouki Zerouali A, Melgar E, Henry J, Schmutz JL, et al. A study of corticophobia in adult psoriasis patients: a French cross-sectional observational study. J Eur Acad Dermatol Venereol. 2021;35(11):e768-e70. doi:10.1111/jdv.17435.
  • 8. Beattie PE, Lewis-Jones MS. Parental knowledge of topical therapies in the treatment of childhood atopic dermatitis. Clin Exp Dermatol. 2003;28(5):549-53. doi:10.1046/j.1365-2230.2003.01357.x.
  • 9. Hix E, Gustafson CJ, O'Neill JL, Huang K, Sandoval LF, Harrison J, et al. Adherence to a five day treatment course of topical fluocinonide 0.1% cream in atopic dermatitis. Dermatol Online J. 2013;19(10):20029.
  • 10. Martin SL, McGoey ST, Bebo BF, Jr., Feldman SR. Patients' educational needs about topical treatments for psoriasis. J Am Acad Dermatol. 2013;68(6):e163-8. doi:10.1016/j.jaad.2012.04.016.
  • 11. Johnson Girard V, Hill A, Glaser E, Lussier MT. Optimizing Communication About Topical Corticosteroids: A Quality Improvement Study [Formula: see text]. J Cutan Med Surg. 2020;24(3):240-8. doi:10.1177/1203475420908250.
  • 12. Caldarola G, De Simone C, Moretta G, Poscia A, Peris K. Role of personalized medication training in improving efficacy and adherence to a topical therapy in psoriatic patients. J Dermatolog Treat. 2017;28(8):722-5. doi:10.1080/09546634.2017.1328100.
  • 13. Delpero E, Sriharan A, Selk A. Steroid Phobia in Patients With Vulvar Lichen Sclerosus. J Low Genit Tract Dis. 2023;27(3):286-90. doi:10.1097/lgt.0000000000000753.
  • 14. Koster ES, Philbert D, Zheng X, Moradi N, de Vries TW, Bouvy ML. Reducing corticosteroid phobia in pharmacy staff and parents of children with atopic dermatitis. Int J Clin Pharm. 2021;43(5):1237-44. doi:10.1007/s11096-021-01241-2.
  • 15. Pathak GN, Chandy RJ, Shah R, Feldman SR. The Pharmacist's role in dermatology: Patient medication adherence. J Dermatol. 2023;50(9):1099-107. doi:10.1111/1346-8138.16895.
  • 16. Lee JY, Her Y, Kim CW, Kim SS. Topical Corticosteroid Phobia among Parents of Children with Atopic Eczema in Korea. Ann Dermatol. 2015;27(5):499-506. doi:10.5021/ad.2015.27.5.499.
  • 17. Kew CH, Ahmad Basir KF, Low DW, Loh KC. Breaking through the steroid stigma: a single-centre study on topical corticosteroid perception and adherence in dermatology patients and caregivers. Med J Malaysia. 2023;78(4):437-44.
  • 18. Albogami MF, AlJomaie MS, Almarri SS, Al-Malki S, Tamur S, Aljaid M, et al. Topical Corticosteroid Phobia Among Parents of Children with Atopic Dermatitis (Eczema)- A Cross-Sectional Study. Patient Prefer Adherence. 2023;17:2761-72. doi:10.2147/ppa.S431719.
  • 19. Contento M, Cline A, Russo M. Steroid Phobia: A Review of Prevalence, Risk Factors, and Interventions. Am J Clin Dermatol. 2021;22(6):837-51. doi:10.1007/s40257-021-00623-6.
  • 20. Bos B, Antonescu I, Osinga H, Veenje S, de Jong K, de Vries TW. Corticosteroid phobia (corticophobia) in parents of young children with atopic dermatitis and their health care providers. Pediatr Dermatol. 2019;36(1):100-4. doi:10.1111/pde.13698.
  • 21. Song SY, Jung SY, Kim E. Steroid phobia among general users of topical steroids: a cross-sectional nationwide survey. J Dermatolog Treat. 2019;30(3):245-50. doi:10.1080/09546634.2018.1508817.
  • 22. 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 Dermatolog Treat. 2015;26(5):418-25. doi:10.3109/09546634.2015.1025030.
  • 23. Ossanai Schoenardie B, Fortes Escobar G, Pauli Damke J, Cardozo Müller G, Rangel Bonamigo R. Corticophobia and adherence to topical corticosteroids in atopic dermatitis treatment in southern Brazil. An Bras Dermatol. 2024. doi:10.1016/j.abd.2023.04.008.
  • 24. Li Y, Han T, Li W, Li Y, Guo X, Zheng L. Awareness of and phobias about topical corticosteroids in parents of infants with eczema in Hangzhou, China. Pediatr Dermatol. 2018;35(4):463-7. doi:10.1111/pde.13527.
  • 25. Masood S, Jalil P, Awan S, Ghulam U, Kerawala SR. Assessment of topical steroid phobia in dermatology patients, a cross-sectional study from an urban area of Pakistan. J Dermatolog Treat. 2022;33(4):2331-4. doi:10.1080/09546634.2021.1959505.

Topikal Kortikosteroid Kullanımında İlaç Uyumuna Hasta Bakış Açısı

Year 2025, Volume: 16 Issue: 2, 144 - 152, 18.08.2025
https://doi.org/10.22312/sdusbed.1467584

Abstract

Amaç: Dermatolojide topikal tedaviye uyum düşüktür. Topikal kortikosteroidler (TKS) dermatoloji pratiğinde sık kullanılan, etkin bir tedavidir. Fakat hastalar bu ilaçlara karşı yersiz korku yaşamakta ve ilaç kullanımı kötü etkilenmektedir. Çalışmada amaç ilacın reçete edildiği andan reçetenin alındığı ana kadar uyumu etkileyebilecek faktörleri incelemektir.

Gereç ve yöntem: Çalışma kartopu örnekleme metodu ile internet yoluyla gerçekleştirilmiştir. Hazırlanan anket formu ile toplanan verilerin analizi SPSS 25.0 ile yapılmıştır. İstatistiksel olarak anlamlı p değeri p<0,05’tir.

Bulgular: Çalışmaya 136 kişi TKS katılmıştır. Katılımcıların %90’ından fazlası hekimin ilaç kullanımını anlattığını ve farklı öneriler olsa da hekimin tarifindeki gibi kullandığını ifade etmiştir. Anladığından emin olma ve aklında kalma puanı 10 puanlık ölçekte 8’in üzerindedir. Topikal steroid kaygılarına 10 tam puan verme katılımcıların %20’sinde gözlenmiştir. Hekim ve eczane deneyimi TKS kullanımı geri bildirimlerinde etkilidir. Kadınlarda çocuğu ile ilgili kaygılar erkeklere göre, çocuğu için ve hem kendisi hem çocuğu için kullananlarda kaygı daha yüksektir.

Tartışma: Hekim ve eczacı süreçlerinde çok fazla problem yaşanmamaktadır. Fakat eczane ayağında hastalar yanlış bilgiye maruz kalabilmektedir. Bu durum TKS korkusunu etkilemektedir. TKS kaygısı katılımcılarda makul düzeydedir. Bu korku çocuk için kullanımda kadınlarda ve yaş ile artmaktadır.

Sonuç: Hastaların hekim sonrası süreçte yanlış bilgilendirilmesinin önüne geçmek amacıyla dermatoloji hekimi dışı kaynakların özellikle eczane ayağının bilinçlendirilmesi, dermatoloji hekimi, diğer hekimler ve eczane üçlüsünün paralel çalışma biçimi faydalı olabilir.

References

  • 1. Okwundu N, Cardwell LA, Cline AE, Richardson IM, Feldman SR. Adherence to topical treatment can improve treatment-resistant moderate psoriasis. Cutis. 2020;105(2):89-91;e2;e3.
  • 2. Krejci-Manwaring J, McCarty MA, Camacho F, Carroll CL, Johnson K, Manuel J, et al. Adherence with topical treatment is poor compared with adherence with oral agents: implications for effective clinical use of topical agents. J Am Acad Dermatol. 2006;54(5 Suppl):S235-6. doi:10.1016/j.jaad.2005.10.060.
  • 3. Alsubeeh NA, Alsharafi AA, Ahamed SS, Alajlan A. Treatment Adherence Among Patients with Five Dermatological Diseases and Four Treatment Types - a Cross-Sectional Study. Patient Prefer Adherence. 2019;13:2029-38. doi:10.2147/ppa.S230921.
  • 4. 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(2):211-6. doi:10.1016/j.jaad.2006.05.073.
  • 5. Morley KW, Dinulos JG. Update on topical glucocorticoid use in children. Curr Opin Pediatr. 2012;24(1):121-8. doi:10.1097/MOP.0b013e32834ef53d.
  • 6. Finnegan P, Murphy M, O'Connor C. #corticophobia: a review on online misinformation related to topical steroids. Clin Exp Dermatol. 2023;48(2):112-5. doi:10.1093/ced/llac019.
  • 7. Moreau E, Rousseau H, Marzouki Zerouali A, Melgar E, Henry J, Schmutz JL, et al. A study of corticophobia in adult psoriasis patients: a French cross-sectional observational study. J Eur Acad Dermatol Venereol. 2021;35(11):e768-e70. doi:10.1111/jdv.17435.
  • 8. Beattie PE, Lewis-Jones MS. Parental knowledge of topical therapies in the treatment of childhood atopic dermatitis. Clin Exp Dermatol. 2003;28(5):549-53. doi:10.1046/j.1365-2230.2003.01357.x.
  • 9. Hix E, Gustafson CJ, O'Neill JL, Huang K, Sandoval LF, Harrison J, et al. Adherence to a five day treatment course of topical fluocinonide 0.1% cream in atopic dermatitis. Dermatol Online J. 2013;19(10):20029.
  • 10. Martin SL, McGoey ST, Bebo BF, Jr., Feldman SR. Patients' educational needs about topical treatments for psoriasis. J Am Acad Dermatol. 2013;68(6):e163-8. doi:10.1016/j.jaad.2012.04.016.
  • 11. Johnson Girard V, Hill A, Glaser E, Lussier MT. Optimizing Communication About Topical Corticosteroids: A Quality Improvement Study [Formula: see text]. J Cutan Med Surg. 2020;24(3):240-8. doi:10.1177/1203475420908250.
  • 12. Caldarola G, De Simone C, Moretta G, Poscia A, Peris K. Role of personalized medication training in improving efficacy and adherence to a topical therapy in psoriatic patients. J Dermatolog Treat. 2017;28(8):722-5. doi:10.1080/09546634.2017.1328100.
  • 13. Delpero E, Sriharan A, Selk A. Steroid Phobia in Patients With Vulvar Lichen Sclerosus. J Low Genit Tract Dis. 2023;27(3):286-90. doi:10.1097/lgt.0000000000000753.
  • 14. Koster ES, Philbert D, Zheng X, Moradi N, de Vries TW, Bouvy ML. Reducing corticosteroid phobia in pharmacy staff and parents of children with atopic dermatitis. Int J Clin Pharm. 2021;43(5):1237-44. doi:10.1007/s11096-021-01241-2.
  • 15. Pathak GN, Chandy RJ, Shah R, Feldman SR. The Pharmacist's role in dermatology: Patient medication adherence. J Dermatol. 2023;50(9):1099-107. doi:10.1111/1346-8138.16895.
  • 16. Lee JY, Her Y, Kim CW, Kim SS. Topical Corticosteroid Phobia among Parents of Children with Atopic Eczema in Korea. Ann Dermatol. 2015;27(5):499-506. doi:10.5021/ad.2015.27.5.499.
  • 17. Kew CH, Ahmad Basir KF, Low DW, Loh KC. Breaking through the steroid stigma: a single-centre study on topical corticosteroid perception and adherence in dermatology patients and caregivers. Med J Malaysia. 2023;78(4):437-44.
  • 18. Albogami MF, AlJomaie MS, Almarri SS, Al-Malki S, Tamur S, Aljaid M, et al. Topical Corticosteroid Phobia Among Parents of Children with Atopic Dermatitis (Eczema)- A Cross-Sectional Study. Patient Prefer Adherence. 2023;17:2761-72. doi:10.2147/ppa.S431719.
  • 19. Contento M, Cline A, Russo M. Steroid Phobia: A Review of Prevalence, Risk Factors, and Interventions. Am J Clin Dermatol. 2021;22(6):837-51. doi:10.1007/s40257-021-00623-6.
  • 20. Bos B, Antonescu I, Osinga H, Veenje S, de Jong K, de Vries TW. Corticosteroid phobia (corticophobia) in parents of young children with atopic dermatitis and their health care providers. Pediatr Dermatol. 2019;36(1):100-4. doi:10.1111/pde.13698.
  • 21. Song SY, Jung SY, Kim E. Steroid phobia among general users of topical steroids: a cross-sectional nationwide survey. J Dermatolog Treat. 2019;30(3):245-50. doi:10.1080/09546634.2018.1508817.
  • 22. 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 Dermatolog Treat. 2015;26(5):418-25. doi:10.3109/09546634.2015.1025030.
  • 23. Ossanai Schoenardie B, Fortes Escobar G, Pauli Damke J, Cardozo Müller G, Rangel Bonamigo R. Corticophobia and adherence to topical corticosteroids in atopic dermatitis treatment in southern Brazil. An Bras Dermatol. 2024. doi:10.1016/j.abd.2023.04.008.
  • 24. Li Y, Han T, Li W, Li Y, Guo X, Zheng L. Awareness of and phobias about topical corticosteroids in parents of infants with eczema in Hangzhou, China. Pediatr Dermatol. 2018;35(4):463-7. doi:10.1111/pde.13527.
  • 25. Masood S, Jalil P, Awan S, Ghulam U, Kerawala SR. Assessment of topical steroid phobia in dermatology patients, a cross-sectional study from an urban area of Pakistan. J Dermatolog Treat. 2022;33(4):2331-4. doi:10.1080/09546634.2021.1959505.
There are 25 citations in total.

Details

Primary Language Turkish
Subjects Dermatology
Journal Section Araştırma Articlesi
Authors

Kadir Küçük 0000-0001-6633-2292

Pelin Kartal 0000-0001-7310-8635

Publication Date August 18, 2025
Submission Date August 16, 2024
Acceptance Date April 4, 2025
Published in Issue Year 2025 Volume: 16 Issue: 2

Cite

Vancouver Küçük K, Kartal P. Topikal Kortikosteroid Kullanımında İlaç Uyumuna Hasta Bakış Açısı. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2025;16(2):144-52.

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