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)

引言与目标：皮质类固醇副作用之恐惧在皮肤病学中颇为常见，导致患者用药依从性下降。本试验旨在探讨针对性教育在减少局部皮质类固醇恐惧症方面的有效性。

方法：本项双盲、随机对照试验中，干预组参与者接受了针对局部皮质类固醇常见误解的教育视频及患者信息手册。采用TOPICOP©量表评估皮质类固醇恐惧症，ECOB评分评估用药依从性，DLQI评估生活质量。

结果：275名患者被随机分组。干预组患者的TOPICOP©量表平均（标准差）得分在1个月和3个月时分别从41.9（SD，17.4）降至37.1（SD，20.0）和33.8（SD，19.0），这种下降主要源于知识领域的改善，而非恐惧和行为领域。调整人口统计学混杂因素后，这一改善仍具有统计学意义，预期减少4.22分（p=0.031）。在考虑人口统计学因素后，用药依从性和生活质量方面无统计学差异。

结论与相关性：在单一时间点进行针对性教育主要改善了知识领域的TOPICOP©得分，但在恐惧领域并未改善。

临床试验注册号：ClinicalTrials.gov（标识符：NCT03658252）