Predictors of Topical Corticosteroid Adherence Among Caregivers of Children with Atopic Eczema

Elaine Li Fong Liew,1 Noraida Mohamed Shah,1 Wei Wen Chong,1 Latha R Selvarajah,2 Ummi Syahida Sulaiman,1 Nirmala Ponnuthurai3 1Centre of Quality Management of Medicine, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Kuala Lumpur, 50300, Malaysia; 2Dermatology Department, Hospital Sultan Ismail, Jalan Persiaran Mutiara Emas Utama, Taman Mount Austin, Johor Bahru, 81100, Malaysia; 3Pediatric Dermatology Unit, Pediatric Department, Hospital Tunku Azizah, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Kuala Lumpur, 50300, MalaysiaCorrespondence: Noraida Mohamed Shah, Centre of Quality Management of Medicine, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Kuala Lumpur, 50300, Malaysia, Tel +60392898038, Email [email protected]: Poor adherence to topical treatment regimens is linked to treatment failure and results in using systemic agents with more toxic effects. Studies on the factors that affect caregivers’ adherence, especially in using topical corticosteroid (TCS) are still lacking. This study aims to determine the adherence score to TCS among caregivers of children with atopic eczema (AE) and the predictors of their adherence.Patient and Methods: Caregivers of children with AE who used TCS in the past three months at the dermatology clinic of two major hospitals were recruited to complete a self-reported survey on the child’s eczema severity, degree of TCS phobia using TOPICOP© and caregivers’ adherence to TCS using a 12-item medication adherence scale. Multiple linear regression was utilised to determine the predictors of caregivers’ adherence.Results: Responses were received from 121 caregivers, with mean age of 35.9 years (SD ± 5.43) and 73.6% (n = 89) were females. The mean global TOPICOP© score was 25.4% (SD ± 14.5) and the mean adherence score was 48.5 (SD ± 6.6; maximum score = 60). Severe eczema (B = 4.330, CI 1.907 to 6.754, p < 0.001) and those who do not know the name of their child’s medication (B = 6.922, CI 2.126 to 11.718, p < 0.05) were positive predictors of TCS adherence. TCS phobia was a negative predictor of TCS adherence (B = − 0.300, CI − 0.449 to − 0.510, p < 0.001).Conclusion: Caregivers of children with AE showed good adherence score towards TCS use. Addressing TCS phobia may improve TCS adherence among caregivers of children with AE.Keywords: atopic eczema, caregivers, topical corticosteroid adherence, topical corticosteroid phobia, predictors