ArticlePatient preference and adherence2026
The Paradox of Education and the Failure of Communication: A Cross-Sectional Study of Topical Corticosteroid Phobia and Its Impact on Treatment Adherence Among Urban Primary Care Patients in Shenzhen, China.
Article in Patient preference and adherence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Topical corticosteroid (TCS) phobia is increasingly recognized as a barrier to treatment adherence in dermatology. However, evidence from community-based primary care settings in urban China remains limited. Understanding patient perceptions in these settings is essential for improving adherence and promoting shared decision-making. Purpose: To investigate the prevalence of TCS phobia among urban primary care patients in Shenzhen, identify associated factors, and evaluate its influence on treatment preferences and adherence behaviors. Patients and Methods: A cross-sectional survey was conducted among community residents attending urban primary care clinics using an anonymous electronic questionnaire. Of the 300 eligible patients approached, 199 provided valid responses, yielding a response rate of 66.3%. An anonymous electronic questionnaire captured demographic data, TCS knowledge, attitudes, information sources, and treatment behaviors. Associations with TCS phobia were assessed using Chi-square tests. Results: TCS phobia was reported by 26.1% of participants. Higher educational attainment was significantly associated with greater phobia ( Conclusion: TCS phobia is common among educated urban primary care patients and is driven primarily by incorrect beliefs about systemic toxicity. These fears have direct, negative consequences on treatment adherence. Current communication strategies appear insufficient. Patient-centered counseling that directly addresses misconceptions and emphasizes the distinction between topical and systemic corticosteroids is urgently needed in primary care practice.
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