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Exploring Treatment Adherence in Children Aged 0-6 With Atopic Dermatitis: A Pilot Cross-Sectional Study in China
Zizhuo Li1, Xinming Mai2,3, Yan Liao2
1Department of Dermatology, First Medical Center of Chinese PLA General Hospital, Beijing, China.
Insights
Caregiver adherence to atopic dermatitis (AD) treatment in Chinese children is low, with treatment convenience being a key factor. Improving convenience may enhance adherence for pediatric eczema management.
Area of Science:
- Pediatric Dermatology
- Chronic Inflammatory Diseases
- Health Services Research
Background:
- Atopic dermatitis (AD) is a prevalent chronic skin condition in children.
- Treatment adherence is a significant challenge in managing pediatric AD.
- Understanding caregiver perspectives is crucial for improving treatment outcomes.
Purpose of the Study:
- To evaluate caregiver perceptions of treatment for pediatric atopic dermatitis in China.
- To identify factors influencing treatment adherence among caregivers of children with AD.
- To assess the impact of treatment convenience and corticophobia on adherence.
Main Methods:
- A cross-sectional study was conducted involving 100 children with AD.
- Caregivers completed questionnaires including the Topical Corticosteroid Phobia (TOPICOP) scale, Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9), and Morisky Medication Adherence Scale (MMAS-8).
- Demographic, disease severity, and treatment adherence data were collected and analyzed.
Main Results:
- Overall adherence was low, with 72% of caregivers showing low adherence.
- Lower adherence was associated with lower ratings of treatment convenience.
- Caregiver gender and child's gender were associated with higher adherence, while education and corticophobia were not significant factors.
Conclusions:
- Current treatment adherence for pediatric eczema in China is suboptimal.
- Treatment convenience emerges as a critical factor influencing caregiver adherence.
- Interventions should focus on improving the ease of treatment administration to enhance adherence.
Background/Objectives:
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.
Methods:
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).
Results:
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.
Conclusions:
The current treatment approach for children with eczema in China was generally poor, and treatment convenience was an important factor influencing caregiver adherence.
