Prevalence of topical corticosteroids related adverse drug events and associated factors in selected community pharmacies and cosmetic shops of Addis Ababa, Ethiopia

Abstract

Introduction: Inappropriate use of topical corticosteroids was found to cause different dermatological complications. Despite its complex adverse effects, misuse of topical corticosteroids has been a common practice throughout the world. The objective of this study was to assess the prevalence of misuse of topical corticosteroids and its associated factors in selected community pharmacies and cosmetics shops of Addis Ababa. Methods:A cross-sectional study design was conducted from February to April in twelve community pharmacies and six cosmetics shops in Addis Ababa. A convenience sampling method using semi-structured interviews was used to collect topical corticosteroids use pattern and related adverse events. Descriptive statistics were used to summarize the nature and frequency of cosmetic use while binary and multinomial logistic regression was employed to test associated factors. Statistical significance was set at p<0.05.Result: From a total of 286 participants, more than two third obtained the topical corticosteroids as over the counter. Among these, majority (59.8%) used for beautification purpose. More than half of the users faced adverse drug events and the most common affected site was face. Educational status was found to be associated with OTC use of corticosteroids. Age, reading of label, frequency of application, recommendation by friends and, mixing with other cosmetics and water have shown statistically significant association with occurrence of adverse drug events. Conclusion:Majority of the topical corticosteroids were obtained without prescription for the purpose of beautification rather than treatment. A higher proportion of cosmetic users reported to have experienced at least one adverse event. There needs to consider safety concerns related to topical corticosteroids use in the city.

Real‐world safety evaluation of topical corticosteroid use: A community pharmacy‐based, prospective, observational study

“…A recent cross‐sectional study in Ethiopia showed that 52.4% of 286 participants who used TCs from community pharmacy and cosmetic shops reported different kinds of ADEs . This high prevalence and big difference in our current study could be explained by the different distribution systems and sales regulations of TC preparations, regulatory strategies to promote rational drug use and perception regarding medication use among countries.…”

“…A recent cross-sectional study in Ethiopia showed that 52.4% of 286 participants who used TCs from community pharmacy and cosmetic shops reported different kinds of ADEs. 12 This high prevalence and big difference in our current study could be explained by the different distribution systems and sales regulations of TC preparations, regulatory strategies to promote rational drug use and perception regarding medication use among countries. An observational study in Japan reported that the cumulative incidence of skin atrophy in the antecubital fossae that is associated with the use of TCs in adolescent and adult patients with atopic dermatitis is 15.8%.…”

“…Considering the concerns that TC phobia, attributed to the non‐validated public information about exaggerated ADEs of TC use, prevents patients or caregivers from using the necessary TCs for disease control, estimating the incidence and characteristics of adverse drug events (ADEs) related to TCs in the real‐world use is warranted. However, understanding the exact incidence and pattern of ADEs related to TC use is difficult because most reports were from case studies or case series or cross‐sectional studies …”

“…However, understanding the exact incidence and pattern of ADEs related to TC use is difficult because most reports were from case studies or case series or cross-sectional studies. 3,[5][6][7][8][9][10]12 Prescription drugs are presumably used as directed by the physician, while non-prescription or over-the-counter (OTC) medications are used according to their label instructions. 13 To understand the real-world utility pattern and ADE prevalence of TCs, cohorts including users of prescription and OTC TCs should be evaluated.…”