Does it work and is it safe? Parents' perspectives on adherence to medication for atopic dermatitis

Abstract

Background: Though adherence is low among caregivers of children with atopic dermatitis (AD), the reasons for it are poorly understood. This study aims to assess the self-reported prevalence of non-adherence and reasons for changing prescription regimens among parents of children with AD. Methods: A link to a 15-question online survey was posted to social media sites engaging parents of children with eczema, worldwide. Items included a scale related to physician trust. Results were analyzed using R 3.4 and summarized using normal and nonparametric descriptive statistics as appropriate for each item. Results: Eighty-six eligible parents responded to the survey and provided information about medication adherence. The mean age of respondents' children was 6.2 years (SD 4.4 years), and the majority were children with moderate or severe eczema (40.5% moderate and 42.9% severe). Just over half (54.7%) reported taking or applying eczema medications as directed by their physician. Of those that did not, 30.2% took or applied less medications, and 12.8% stopped taking or applying medications altogether. The top reasons for deviating from directions were as follows: (a) worry about side effects, (b) symptom resolution, and (c) perception that the medication was not working. Trust toward physician was significantly associated with taking medication as directed. Conclusions: Decisions about adherence to medications are made in the context of perceived benefits versus anticipated side effects. Findings highlight opportunities for improving adherence, and thereby improving outcomes for children with moderate-severe AD.