title: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: a Department of Dermatology , University Hospital Basel, University of Basel , Switzerland.
authors.forename: Simon M
authors.initials: SM
authors.lastname: Mueller
authors.affiliation: a Department of Dermatology , University Hospital Basel, University of Basel , Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Itin
authors.affiliation: b Clinical Trial Unit, University Hospital Basel, University of Basel , Switzerland.
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Vogt
authors.affiliation: c Psychiatric University Clinic (UPK) Basel, University of Basel , Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Walter
authors.affiliation: c Psychiatric University Clinic (UPK) Basel, University of Basel , Switzerland.
authors.forename: Undine
authors.initials: U
authors.lastname: Lang
authors.affiliation: d Dermatology Centre, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, University of Manchester , Manchester , UK.
authors.forename: Liezel L
authors.initials: LL
authors.lastname: Griffin
authors.affiliation: b Clinical Trial Unit, University Hospital Basel, University of Basel , Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Euler
mesh_terms: D000279:Administration, Cutaneous; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010045:Outpatients; D010698:Phobic Disorders / Q000175:diagnosis* / Q000523:psychology; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012871:Skin Diseases / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D005938:Glucocorticoids
keywords: Adherence; clinical tool; diagnostic tool; phobia; topical steroids