Patient Awareness, Adverse Reactions, And Levels Of Corticophobia In A Tertiary Care Setting

Abstract

Objectives: Corticosteroids are extensively used in clinical practice for their anti-inflammatory and immunosuppressive properties. However, their use is often associated with significant side effects and the phenomenon of corticophobia, which is the irrational fear of using corticosteroids. The objective of this study is to assess drug-related problems in corticosteroid therapy and identify corticophobia among patients using corticosteroids.

Materials and Methods: A prospective observational study, conducted over nine months in General Medicine, Nephrology, and Respiratory Medicine departments, assessed ADRs in 110 participants. Causality, preventability, and severity were evaluated through clinical records, lab tests, and patient interviews. Corticophobia was assessed using a structured self-administered questionnaire, with data analyzed using descriptive and inferential statistics.

Results: A total of 360 patients were screened, and 102 patients receiving corticosteroid medication were identified, with nearly equal sex distribution. A total of 55 ADRs were identified among the enrolled subjects, with a prevalence rate of 49.01%. The main adverse drug reactions observed were hyperglycemia (11.76%), hypokalemia (9.80%), and hypertension (3.92%). In addition, rare ADRs such as epistaxis, steroid-induced leukocytosis, hypothalamic-pituitary-adrenal axis suppression, osteoporosis, and Cushing’s syndrome were identified. These ADRs were categorized by organ system, revealing metabolic (11.76%), cardiovascular (3.92%), and electrolyte (9.80%) effects, respectively. ADRs assessed according to the Naranjo causality assessment scale were classified as probable (24.51%) and possible (75.49%), with a predominant severity level of 1 (56.8%). Additionally, 80.39% of ADRs were identified as definitely preventable. A significant proportion (48%) had low fear of corticosteroid medications, while 15% experienced high fear of administration and dosage. Notably, high fear (60%) contributes to intentional dose-skipping.

Conclusion: This study highlights a significant prevalence of ADRs in patients receiving corticosteroids, with hyperglycemia, hypokalemia, and hypertension being common. Most ADRs were preventable, emphasizing the need for careful monitoring and management.