Topical Corticosteroid Phobia among Parents of Children with Atopic Eczema in Korea
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Background: Topical 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. Objective: To assess the current state of steroid phobia among parents of atopic children in Korea and to investigate the importance of education in its reduction. Methods: By 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. Results: Overall, 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). Conclusion: We 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.
Abstract
Background: Topical 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. Objective: To assess the current state of steroid phobia among parents of atopic children in Korea and to investigate the importance of education in its reduction. Methods: By 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. Results: Overall, 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). Conclusion: We 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.
참고문헌 (25)
- Thomas Bieber, "Atopic Dermatitis", Annals of Dermatology, 22(2), pp.125~137 (2010), 대한피부과학회
- Williams HC, "Clinical practice. Atopic dermatitis", N Engl J Med, 352, pp.2314~2324 (2005)
- Chamlin SL, "The psychosocial burden of childhood atopic dermatitis", Dermatol Ther, 19, pp.104~107 (2006)
- Yang HJ, "Evaluation of patient's subjective severity using various scoring system in Korean children with atopic dermatitis", Asian Pac J Allergy Immunol, 28, pp.130~135 (2010)
- Zuberbier T, "Patient perspectives on the management of atopic dermatitis", J Allergy Clin Immunol, 118, pp.226~232 (2006)
- 김세연, "국소 스테로이드 제제 사용에 관한 대학 병원 피부과외래 환자의 인식도 및 행태 설문 조사", 대한피부과학회지, 46(4), pp.473~479 (2008), 대한피부과학회
- 진현우, "아토피피부염 환자의 대체의학 이용 실태에 관한 연구", 대한피부과학회지, 43(7), pp.903~911 (2005), 대한피부과학회
- David TJ, "Steroid scare", Arch Dis Child, 62, pp.876~878 (1987)
- Charman CR, "Topical corticosteroid phobia in patients with atopic eczema", Br J Dermatol, 142, pp.931~936 (2000)
- Hon KL, "Steroid fears in children with eczema", Acta Paediatr, 95, pp.1451~1455 (2006)
- Smith SD, "Corticosteroid phobia and other confounders in the treatment of childhood atopic dermatitis explored using parent focus groups", Australas J Dermatol, 51, pp.168~174 (2010)
- Aubert-Wastiaux H, "Topical corticosteroid phobia in atopic dermatitis: a study of its nature, origins and frequency", Br J Dermatol, 165, pp.808~814 (2011)
- Kojima R, "Factors associated with steroid phobia in caregivers of children with atopic dermatitis", Pediatr Dermatol, 30, pp.29~35 (2013)
- Hanifin JM, "Diagnostic features of atopic dermatitis", Acta Derm Venereol Suppl (Stockh), 60(Suppl 92), pp.44~47 (1980)
- Charman CR, "The patient-oriented eczema measure: development and initial validation of a new tool for measuring atopic eczema severity from the patients' perspective", Arch Dermatol, 140, pp.1513~1519 (2004)
- Charman CR, "Translating Patient-Oriented Eczema Measure (POEM) scores into clinical practice by suggesting severity strata derived using anchor-based methods", Br J Dermatol, 169, pp.1326~1332 (2013)
- Burrichter A, "Fear of cortisone in bronchial asthma. A parent survey", Monatsschr Kinderh, 154, pp.979~985 (2006)
- Ohya Y, "Psychosocial factors and adherence to treatment advice in childhood atopic dermatitis", J Invest Dermatol, 117, pp.852~857 (2001)
- Fukaya M, "Why do patients with atopic dermatitis refuse to apply topical corticosteroids?", Dermatology, 201, pp.242~245 (2000)
- Bewley A, "Expert consensus:time for a change in the way we advise our patients to use topical corticosteroids", Br J Dermatol, 158, pp.917~920 (2008)
- Oranje AP, "de Waard-van der Spek FB. Practical issues on interpretation of scoring atopic dermatitis: the SCORAD index, objective SCORAD and the three-item severity score", Br J Dermatol, 157, pp.645~648 (2007)
- Rao VU, "Steroid phobia and adherence--problems, solutions, impact on benefit", risk profile, 2005, pp.25, 581~595
- Hengge UR, "Adverse effects of topical glucocorticosteroids", J Am Acad Dermatol, 54, pp.1~15 (2006)
- Cook LJ, "Iatrogenic hyperadrenocorticism during topical steroid therapy:assessment of systemic effects by metabolic criteria", J Am Acad Dermatol, 6, pp.1054~1060 (1982)
- 권현조, "아토피 피부염과 관련된 국내 인터넷상의 정보에 대한 연구", 대한피부과학회지, 44(2), pp.137~140 (2006), 대한피부과학회