Efficacy of Targeted Education In Reducing Topical Steroid Phobia, A Randomised Clinical Trial

Introduction and objectives: Fear of side effects of corticosteroids is common in dermatology and results in medication non-adherence. The objective of this trial was to study the efficacy of targeted education in reducing topical steroid phobia. Methods: In this double-blinded, randomized controlled trial, participants in the intervention arm were presented with an educational video and patient information leaflet targeting common misconceptions of topical corticosteroids. Steroid phobia was assessed with the TOPICOP© scale, medication adherence with the ECOB score, and quality of life with the DLQI. Results: 275 patients were randomised. Mean (SD) TOPICOP© score in the intervention arm decreased (improved) from 41.9 (SD,17.4) to 37.1 (SD,20.0) and 33.8 (SD,19.0) at 1 month and 3 months, respectively with the reduction arising from the knowledge domain but not the fears and behaviours domain. This remained statistically significant after adjusting for demographic confounding with an expected reduction of 4.22 points (p=0.031). After accounting for demographic factors, there was no statistical difference in medication adherence and quality of life. Conclusions and Relevance: Targeted education at a single time point improved the TOPICOP© score primarily in the knowledge domain but not in the fear domain. Trial registration number: ClinicalTrials.gov (Identifier: NCT03658252)