The magnitude of fear of adverse effects as a reason for nonparticipation in drug treatment: a short review.

The extent and reasons for nonparticipation in preventive drug intervention programs were reviewed. Special attention was paid to the magnitude of "steroid-phobia" in cases of early treatment of asthma patients, with inhaled steroids. A Medline search yielded 11 studies. One study addressed the topic of treatment, with inhaled steroids, in early asthma patients. Nonparticipation rates to "early" drug treatment ranged from 0.3% to 48%. Fear of adverse effects and lack of knowledge about the treatment were given as the most important reasons for nonparticipation. Educational measures to increase knowledge about the drug were advised by most of the authors. In the asthma study a specific "steroid-phobia" was not indicated, possibly due to the continuous education about the steroid treatment throughout the study. Proper and repeating information about the safety and the minimal adverse effects of preventive drug treatment, especially inhaled steroids, seems essential to improve the treatment rate.