Caregiver willingness to treat atopic dermatitis is not much improved by anchoring

Abstract

Background: Caregivers are often apprehensive about treating their child’s atopic dermatitis with a topical corticosteroid. Typical concerns include anxiety regarding side effects and the perceived burden of treatment. The perception of burden may be modifiable through anchoring.

Objective: To evaluate caregivers willingness to treat their child’s atopic dermatitis with a topical corticosteroid once-daily if initially anchored to the idea of a four-times-daily treatment regimen.

Methods: A prospective survey study was performed in 100 caregivers of children with atopic dermatitis. Scores were treated as ordinal data and evaluated using the Mann-Whitney U test and chi-squared test.

Results: Of the 100 recruited participants, 97 were eligible and returned completed surveys. Subjects anchored to a four-times-daily treatment regimen were more willing to treat their child’s atopic dermatitis once-daily (mean, 8.7) than those not anchored (mean, 7.9), however the difference between these groups was not statistically significant (p = .173).

Conclusion: Caregivers reported being generally quite willing to apply topical corticosteroids once-daily. Anchoring was associated with a slightly higher score, though it was not statistically significant. For most patients with atopic dermatitis, anchoring may not be helpful, but for patients whose main barrier is perceived burdensomeness of treatment, anchoring may be of some benefit.

Keywords:

• Pediatric
• topical steroids
• eczema
• psychological interventions
• randomized controlled trial

Disclosure statement

Dr. Feldman has received research, speaking and/or consulting support from a variety of companies inclding Galderma, GSK/Stiefel, Almirall, Leo Pharma, Baxter, Boeringer Ingelheim, Mylan, Celgene, Pfizer, Valeant, Taro, Abbvie, Cosmederm, Anacor, Astellas, Janssen, Lilly, Merck, Merz, Novartis, Regeneron, Sanofi, Novan, Parion, Qurient, National Biological Corporation, Caremark, Advance Medical, Sun Pharma, Suncare Research, Informa, UpToDate, and National Psoriasis Foundation. He is founder and majority owner of www.DrScore.com and founder and part owner of Causa Research, a company dedicated to enhancing patients adherence to treatment. Zachary Curry, Matthew C. Johnson, and Emily Unrue have no conflicts of interest to disclose.

Data availability statement

Raw data were generated at the Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. Derived data supporting the findings of this study are available from the corresponding author SRF on request.