The Role of the Clinical Pharmacist in the Identification and Management of Corticophobia – An Interventional Study

Purpose: To explore patients' attitudes and knowledge about corticosteroids, investigate the reasons behind corticophobia (if any), explore the sources and validity of such beliefs, as well as investigate the role of the clinical pharmacist’s intervention in minimizing corticophobia and improving patient compliance.
Methods: The study adopted 2 methodologies: a structured interview technique with patients selected according to inclusion criteria, and a pre- and post-intervention to measure the effect this intervention may have had on patients’ compliance, fear and general behavior towards corticosteroids.
Results: A total of 204 patients were interviewed, most of whom (56.9 %) were female, 41.2 % had several chronic diseases and 41.7 % used steroids for the first time. Fourteen percent of respondents did not know why they had been prescribed corticosteroids. The main source of information about corticosteroids was reported to be "friends and family" (37.7 %) while the main reasons for corticophobia were reported to be theoretical/potential adverse drug reactions (ADRs, 38.5 %), actually experienced ADRs (24.6 %), or the fact that they had heard that corticosteroids were harmful (8 %). The clinical pharmacist's intervention significantly improved patients' compliance and decreased corticophobia (p < 0.001), but it did not significantly affect their general behavior towards corticosteroids (p = 0.07).
Conclusion: In general, patients' sources of information about corticosteroids may be unreliable or invalid; creating a poor background and subsequently lead to corticophobia and poor compliance. Clinical pharmacist intervention has a significant impact on lowering patents' fear of corticosteroids, and improving their compliance with corticosteroids treatment regimens.

Keywords
Corticosteroids; corticophobia; patient compliance; structured interview; steroids; adverse drug reaction