Assessment of “corticophobia” as an indicator of non-adherence to topical corticosteroids: A pilot study

Abstract

Background: Concerns regarding topical corticosteroid (TCS) use, broadly known as “corticophobia”, are highly prevalent among dermatology patients and often result in non-adherence to TCS. This non-adherence contributes to poor disease control and increased health care costs. However, it is unknown if assessment of these concerns might help to identify patients at risk of TCS-non-adherence. Clinical tools indicating non-adherence could be helpful to improve management of this patient group.

Objective: To assess whether the available tools for measuring concerns regarding corticosteroids, the TOPICOP scale and the 0-10 Visual Analogue Scale (VAS), could help to detect non-adherence to TCS.

Methods: In 75 patients with concerns regarding TCS use both the TOPICOP scale and VAS were anonymously assessed. A comparison was made between TCS-adherent and non-adherent patients regarding the intensity and characteristics of their concerns.

Results: The intensity and quality of the concerns varied broadly among the patients. When using the VAS, a score of ≥5 detected 87% of non-adherent patients. The answers to the TOPICOP scale did not discriminate non-adherent from adherent patients.

Conclusion: Using the VAS to assess concerns to use TCS could help identify patients at risk of TCS-non-adherence and facilitate discussion with the patient about potential non-adherence in a more substantiated, non-judgemental way.

Keywords:

• Adherence
• clinical tool
• diagnostic tool
• phobia
• topical steroids

Acknowledgements

The authors are indebted to the study nurses Pia Steinger and Annet Tiemessen for printing the questionnaires and their assistance in patient recruitment.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.