Müller Simon M, Tomaschett Dominique, Euler Sebastian, Vogt Deborah R, Herzog Lisa, Itin Peter
Department of Dermatology, University Hospital Basel, Basel, Switzerland.
Dermatology. 2016;232(4):444-52. doi: 10.1159/000446068. Epub 2016 Jun 21.
BACKGROUND/AIMS: Topical corticosteroid concerns (TCC) are an important issue in patients with atopic dermatitis, leading to non-adherence with poor disease control and increased health care costs. However, neither the prevalence of TCC in a more comprehensible dermatological population nor the impact of patient information on topical corticosteroids given by clinicians is known. Therefore, we assessed the prevalence, characteristics, and sources of TCC in a dermatological population and the impact of written and oral patient information on TCC.
A total of 643 outpatients with various skin diseases answered a 12-item questionnaire while waiting for the doctor's visit. Patients with TCC quantified their concerns on a discrete visual analogue scale before and after patient information, which consisted of written and oral information about topical corticosteroids (TCS) given by dermatologists.
The prevalence of TCC was 41.5%, and that of TCC-related non-adherence was 28.3%. TCC was positively associated with age <60 years, female gender, use of complementary and alternative medicine (CAM) and non-physician health care profession. The leading concerns were skin atrophy, systemic effects, and impairment of the immune system. The most frequent sources of TCC were negative reports by media, family, or friends. Both written and oral patient information significantly reduced TCC. The number needed to benefit from patient information was approximately 2. Non-responders were more often female, TCS-inexperienced, and users of CAM with an intermediate level of education.
TCC are highly prevalent in dermatological patients. Patient information may lower TCC in almost every second patient.
背景/目的：外用糖皮质激素相关担忧（TCC）是特应性皮炎患者的一个重要问题，会导致治疗依从性差、疾病控制不佳以及医疗费用增加。然而，在更具代表性的皮肤科人群中TCC的患病率，以及临床医生提供的患者信息对外用糖皮质激素的影响尚不清楚。因此，我们评估了皮肤科人群中TCC的患病率、特征和来源，以及书面和口头患者信息对TCC的影响。
共有643名患有各种皮肤病的门诊患者在候诊时回答了一份包含12个项目的问卷。有TCC的患者在接受患者信息前后，通过离散视觉模拟量表对其担忧程度进行量化，患者信息包括皮肤科医生提供的关于外用糖皮质激素（TCS）的书面和口头信息。
TCC的患病率为41.5%，与TCC相关的治疗不依从率为28.3%。TCC与年龄<60岁、女性、使用补充和替代医学（CAM）以及非医师医疗职业呈正相关。主要担忧是皮肤萎缩、全身影响和免疫系统损害。TCC最常见的来源是媒体、家人或朋友的负面报道。书面和口头患者信息均显著降低了TCC。从患者信息中受益所需的人数约为2人。未回复者更常为女性、缺乏TCS使用经验且为中等教育水平的CAM使用者。
TCC在皮肤科患者中非常普遍。患者信息可能会使几乎每两名患者中的一名降低TCC。
