Education reduces concerns, improves outcomes for children using topical corticosteroids

Key takeaways:

• Participants watched an educational video about the use and risks of topical corticosteroids.
• Before video education, 62% of caregivers had concerns about topical corticosteroids, compared with 10.7% after.

Video education about topical corticosteroids alleviated caregivers’ concerns and improved outcomes for pediatric patients with eczematous dermatitis, according to a study published in Pediatric Dermatology.

“Topical corticosteroids are widely used for eczema treatment, but concerns about their potential side effects have led to negative attitudes among caregivers, known as TCS concerns or steroid phobia,” Manassaya Sitthisan, MD, of Chulalongkorn University in Bangkok, and colleagues wrote.

The prospective single-center study enrolled 150 caregivers of children aged younger than 18 years who were patients at King Chulalongkorn Memorial Hospital in Bangkok.

Participants completed a questionnaire about family medical history related to eczematous dermatitis, as well as a VAS, scored on a Likert scale of 0 to 10 points. Researchers also assessed participants’ TOPICOP score, which was graded on a Likert scale of 0 to 3 points with a maximum score of 36. The scores were converted to percentages in which higher scores equated to higher level of concern. Following the initial surveys, each participant watched a 6.5-minute educational video about the use and risks of topical corticosteroids, as well as common misconceptions about them. The researchers followed up with the participants 4 weeks later to learn about the clinical outcomes of the patients.

Before watching the video, 62% of caregivers reported having concerns about topical corticosteroids, compared with 10.7% after.

When participants were asked about their beliefs of negative effects of topical corticosteroids, the mean TOPICOP score was 43.81 ± 13.45 before video education, improving to 31.85 ± 16.56 after (P < .001). When asked about their worries and fears related to topical corticosteroids, the mean score was 56.22 ± 18.27 before video education and 40.41 ± 18.55 after (P < .001).

The mean VAS score before video education was 5.75 ± 2.62, decreasing to 1.57 ± 1.88 after (P < .001).

Clinical outcomes for caregivers’ children improved after participants watched the educational video. Nearly one-quarter of patients had no flare-up within 4 weeks, compared with 8% before the study. Whereas 22% experienced more than four flare-ups per month prior to the study, just 8.7% experienced more than four flares after their caregiver watched the video.

“Video education had a positive impact on clinical outcomes after 4 weeks, resulting in a decrease in recurrence rates, duration of the rash and duration of TCS use,” the researchers wrote. “Despite diminished TCS concerns, caregivers adhered to appropriate TCS application instructions, as the usage of TCS for more than 2 weeks decreased.”