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Is corticophobia spreading among pediatricians?—Insights from a self-efficacy survey on the management of pediatric atopic dermatitis

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 (O...

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Autores principales: Andre, Nicolas, Ben Shmuel, Atar, Yahav, Lior, Muallem, Liezl, Golan Tripto, Inbal, Horev, Amir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644026/
https://www.ncbi.nlm.nih.gov/pubmed/37969117
http://dx.doi.org/10.21037/tp-23-271
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author Andre, Nicolas
Ben Shmuel, Atar
Yahav, Lior
Muallem, Liezl
Golan Tripto, Inbal
Horev, Amir
author_facet Andre, Nicolas
Ben Shmuel, Atar
Yahav, Lior
Muallem, Liezl
Golan Tripto, Inbal
Horev, Amir
author_sort Andre, Nicolas
collection PubMed
description 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% vs. 60.4%, P<0.001) had high self-confidence in treating AD with TCS. Males (20.3% vs. 8%, P=0.03), and having gone to medical school outside Israel (22.2% vs. 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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spelling pubmed-106440262023-11-15 Is corticophobia spreading among pediatricians?—Insights from a self-efficacy survey on the management of pediatric atopic dermatitis Andre, Nicolas Ben Shmuel, Atar Yahav, Lior Muallem, Liezl Golan Tripto, Inbal Horev, Amir Transl Pediatr Original Article 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% vs. 60.4%, P<0.001) had high self-confidence in treating AD with TCS. Males (20.3% vs. 8%, P=0.03), and having gone to medical school outside Israel (22.2% vs. 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. AME Publishing Company 2023-10-24 2023-10-30 /pmc/articles/PMC10644026/ /pubmed/37969117 http://dx.doi.org/10.21037/tp-23-271 Text en 2023 Translational Pediatrics. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Andre, Nicolas
Ben Shmuel, Atar
Yahav, Lior
Muallem, Liezl
Golan Tripto, Inbal
Horev, Amir
Is corticophobia spreading among pediatricians?—Insights from a self-efficacy survey on the management of pediatric atopic dermatitis
title Is corticophobia spreading among pediatricians?—Insights from a self-efficacy survey on the management of pediatric atopic dermatitis
title_full Is corticophobia spreading among pediatricians?—Insights from a self-efficacy survey on the management of pediatric atopic dermatitis
title_fullStr Is corticophobia spreading among pediatricians?—Insights from a self-efficacy survey on the management of pediatric atopic dermatitis
title_full_unstemmed Is corticophobia spreading among pediatricians?—Insights from a self-efficacy survey on the management of pediatric atopic dermatitis
title_short Is corticophobia spreading among pediatricians?—Insights from a self-efficacy survey on the management of pediatric atopic dermatitis
title_sort is corticophobia spreading among pediatricians?—insights from a self-efficacy survey on the management of pediatric atopic dermatitis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644026/
https://www.ncbi.nlm.nih.gov/pubmed/37969117
http://dx.doi.org/10.21037/tp-23-271
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