Liew Elaine Li Fong, Mohamed Shah Noraida, Chong Wei Wen, R Selvarajah Latha, Sulaiman Ummi Syahida, Ponnuthurai Nirmala
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.
Dermatology Department, Hospital Sultan Ismail, Jalan Persiaran Mutiara Emas Utama, Taman Mount Austin, Johor Bahru, 81100, Malaysia.
Patient Prefer Adherence. 2025 May 29;19:1593-1601. doi: 10.2147/PPA.S498527. eCollection 2025.
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.
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.
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).
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.
局部治疗方案依从性差与治疗失败相关,并导致使用毒性更大的全身用药。目前仍缺乏关于影响护理人员依从性因素的研究,尤其是在使用外用糖皮质激素(TCS)方面。本研究旨在确定特应性皮炎(AE)患儿护理人员对TCS的依从性得分及其依从性的预测因素。
招募过去三个月内在两家主要医院皮肤科诊所使用过TCS的AE患儿护理人员,以完成一份关于患儿湿疹严重程度、使用TOPICOP©评估的TCS恐惧程度以及护理人员使用12项药物依从性量表对TCS依从性的自我报告调查。采用多元线性回归来确定护理人员依从性的预测因素。
共收到121名护理人员的回复,平均年龄为35.9岁(标准差±5.43),73.6%(n = 89)为女性。TOPICOP©总体平均得分为25.4%(标准差±14.5),平均依从性得分为48.5(标准差±6.6;最高分 = 60)。重度湿疹(B = 4.330,置信区间1.907至6.754,p < 0.001)以及不知道孩子所用药物名称的护理人员(B = 6.922,置信区间2.126至11.718,p < 0.05)是TCS依从性的正向预测因素。TCS恐惧是TCS依从性的负向预测因素(B = -0.300,置信区间 -0.449至 -0.510,p < 0.001)。
AE患儿的护理人员对TCS使用表现出良好的依从性得分。解决TCS恐惧问题可能会提高AE患儿护理人员对TCS的依从性。