Exploring Treatment Adherence in Children Aged 0-6 With Atopic Dermatitis: A Pilot Cross-Sectional Study in China

Atopic dermatitis (AD) is a common chronic inflammatory skin disease in pediatric populations, yet treatment adherence remains a persistent challenge. This study aims to assess caregivers' perceptions of treatment and investigate the factors influencing treatment adherence in children with AD in China.

A cross-sectional study was conducted at the Department of Dermatology, Peking University Shenzhen Hospital, between April and December 2023. Demographic and disease information were collected. Caregivers were assessed using the Topical Corticosteroid Phobia (TOPICOP) questionnaire, the Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9), and the 8-item Morisky Medication Adherence Scale (MMAS-8).

A total of 100 children were enrolled, most with mild-to-moderate disease severity. 88% of patients reported using topical corticosteroids. The median caregiver global TOPICOP score was 55.6% (IQR 41.7%-67.4%) with a standard deviation (SD) of 17.2%. The mean MMAS score was 4.48 (SD 1.42), and the median was 4.75 (IQR 3.50-6.00). Overall, adherence was generally low, with 72% of caregivers demonstrating low adherence, 23% demonstrating medium adherence, and 4% demonstrating high adherence. Caregivers of male children and male caregivers showed significantly higher adherence. Lower caregiver ratings of treatment convenience were associated with poorer adherence, whereas caregiver education level and corticophobia were not associated with adherence.

The current treatment approach for children with eczema in China was generally poor, and treatment convenience was an important factor influencing caregiver adherence.