Is Corticophobia Spreading Among Pediatricians?-Insights from a Self-efficacy Survey on the Management of Pediatric Atopic Dermatitis

Overview

Journal Transl Pediatr

Publisher AME Publishing Company

Specialty Pediatrics

Date 2023 Nov 16

PMID 37969117

Authors

Nicolas Andre

Atar Ben Shmuel

Lior Yahav

Liezl Muallem

Inbal Golan Tripto

Amir Horev

Affiliations

Soon will be listed here.

Abstract

Background: Atopic dermatitis (AD) is a chronic dermatological condition, often diagnosed and managed by pediatricians. However, pediatricians have difficulties with adhering to guidelines, which recommend the use of topical corticosteroids (TCS) as a first-line treatment and oral corticosteroids (OCS) for resistant cases. Our aim was to assess pediatricians' self-confidence in using steroids in the management of pediatric AD, and investigate which characteristics are related to high self-confidence in prescribing corticosteroids (CS).

Methods: We conducted a cross-sectional questionnaire study among Israeli pediatricians between April 2022 and June 2022. Participants were asked to answer questions dealing with self-assessment of prescribing CS in the management of AD.

Results: A total of 171 residents and pediatricians participated in the survey; 86.6% and 28.1% admitted feeling either average or below-average confidence in the prescription of OCS and TCS, respectively. Physicians who were exposed to higher AD patients (P=0.048) and worked at the clinics (88.2% 60.4%, P<0.001) had high self-confidence in treating AD with TCS. Males (20.3% 8%, P=0.03), and having gone to medical school outside Israel (22.2% 10.4%, P=0.09) were all related to high self-efficacy in prescribing OCS. In total, 11.7% of participants confessed to refraining from prescribing steroids because of fear of side effects.

Conclusions: Most pediatricians have below-average confidence in prescribing OCS for the treatment of AD. Males, working in a community setting, and previous exposure improve the confidence level and can be easily considered in future pediatric training programs.

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