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Published on: September 26, 2019
A labelling system improves parental comfort and willingness to use topical corticosteroids for paediatric atopic
F Wilson1, E Harnik2, C Gore2,3
1Department of Medicine Faculty of Medicine Imperial College London London UK.
Insights
Parents of children with atopic dermatitis (AD) showed poor knowledge of topical corticosteroids (TCS). A traffic light labeling system significantly improved their willingness to use TCS, suggesting a potential to enhance treatment adherence.
Area of Science:
- Dermatology
- Paediatrics
- Public Health
Background:
- Atopic dermatitis (AD) is common in children, with topical corticosteroids (TCS) as a primary treatment.
- Inconsistent packaging of TCS with varying potencies causes confusion, potentially impacting treatment adherence.
- Parental knowledge and concerns regarding TCS use require evaluation to improve AD management.
Purpose of the Study:
- To assess parental knowledge and concerns about topical corticosteroids (TCS) for childhood atopic dermatitis (AD).
- To explore the benefits and preferences for a novel TCS-labelling system.
- To identify factors influencing adherence to AD treatment regimens.
Main Methods:
- A mixed-methods approach involving surveys with parents of children with AD.
- Survey 1 included a knowledge quiz and evaluation of TCS-labelling options.
- Qualitative and quantitative data were analyzed statistically and thematically.
Main Results:
- Parents preferred a traffic light system for TCS potency (green, yellow, red).
- A labelling system significantly increased parental willingness and comfort in using TCS (p ≤ 0.001).
- Significant knowledge gaps were identified regarding TCS potency, with many over- or underestimating strength.
Conclusions:
- Parental concerns and poor knowledge regarding TCS use in childhood AD are prevalent.
- A simple TCS labelling system shows promise for improving treatment adherence.
- Further research is needed to develop and evaluate refined labelling prototypes for optimal use and adherence.
Objectives:
In the United Kingdom, atopic dermatitis (AD) affects 20% of children and topical corticosteroids (TCS) are a mainstay of AD treatment regimes. Many TCS have similar packaging despite significant differences in potency frequently leading to confusion, and along with misinformation and steroid phobia, potentially reducing treatment adherence. We aimed to evaluate parents' knowledge/concerns regarding TCS and explore benefits of/preference for a TCS-labelling system.
Method:
Hundred parents of children with AD attending paediatric dermatology and/or allergy appointments completed mixed-methodology Survey 1 (knowledge-quiz, TCS-labelling options, feedback on what supports AD-care). Thirty parents, adolescents, and healthcare professionals completed Survey 2. Qualitative/quantitative data was thematically/statistically analysed (SPSS v25) respectively.
Results:
Parents preferred the traffic light system (green = mild, yellow = moderate, red = potent; n = 71/100) and reported significantly increased willingness and comfort in using TCS if a labelling system was used p ≤ 0.001). Knowledge regarding TCS potency was lacking: 62% (n = 46/74) of mild TCS-users overestimated potency; 51% (n = 67/131) of potent TCS-users underestimated potency. Common concerns were TCS-related skin thinning, long-term side effects and themes for improved AD-care/support included: better information, written plans, access to advice, involvement of certain staff. Parents wanted accessible information in various formats: verbally, electronic resources, leaflets, and education sessions.
Conclusions:
Parents of children with AD confirmed significant concerns and demonstrated poor knowledge regarding TCS use. Our findings suggest that a simple labelling system may improve TCS adherence. Future work to test refined label prototypes and evaluating their impact on adherence and correct use is needed.
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