参与特应性皮炎护理的医护人员的管理策略与皮质类固醇恐惧症：一项荷兰调查
Management Strategies and Corticophobia among Healthcare Professionals Involved in the Care for Atopic Dermatitis: A Dutch Survey.
作者信息
Ragamin Aviël, van Halewijn Karlijn F, Schappin Renske, Witkam Willemijn C A M, Arends Nicolette J T, Hoogeterp Jaap, Bohnen Arthur M, Elshout Gijs, Schuttelaar Marie L A, Pasmans Suzanne G M A
机构信息
Department of Dermatology, Center of Pediatric Dermatology, Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital-Kinderhaven, Rotterdam, The Netherlands,
Department of Dermatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands,
出版信息
Dermatology. 2025;241(2):101-112. doi: 10.1159/000542421. Epub 2024 Nov 4.
INTRODUCTION
Various healthcare professionals (HCPs) deliver care for patients with atopic dermatitis (AD). Although pivotal, management strategies and the relation with corticophobia among HCPs have not been investigated. This study aimed to investigate management strategies for AD and its relation with corticophobia among HCPs.
METHODS
Dutch general practitioners (GPs), youth healthcare physicians (YHPs), pediatricians, dermatologists, pharmacists, and pharmacy assistants participated in a survey on management strategies and corticophobia. The Topical Corticosteroid Phobia questionnaire for professionals (TOPICOP-P) was used to measure attitudes toward topical corticosteroids (TCSs). Higher scores reflect a more negative attitude.
RESULTS
A total of 407 HCPs (124 GPs, 33 YHPs, 51 pediatricians, 56 dermatologists, 58 pharmacists, and 85 pharmacy assistants) participated. Compared to dermatologists, other HCPs showed greater reluctance to TCS. This difference was highlighted by the finding that half of GPs reported to prescribed only TCS of mild potency for infants with severe AD, while few dermatologists (9%) reported a similar approach. Dermatologists had lowest TOPICOP-P scores (median: 19, IQR: 12-28). GPs and pharmacy assistants had highest scores (GPs median: 36, IQR: 31-44, pharmacy assistants: median: 36, IQR: 31-42). More corticophobia was significantly associated with prescription of a lower TC potency class in prescribing HCPs (B -0.04, 95% CI: -0.07 to 0.01, p = 0.01), and a trend was found between more corticophobia and longer perceived durability of one TCS tube.
CONCLUSIONS
This study shows the differences in management of AD and reluctance toward TCS in HCPs. Furthermore, corticophobia among HCPs and its influence on the selection of TCS potency class and recommendations were demonstrated. To reduce corticophobia and improve care for AD, more education is needed.
INTRODUCTION
Various healthcare professionals (HCPs) deliver care for patients with atopic dermatitis (AD). Although pivotal, management strategies and the relation with corticophobia among HCPs have not been investigated. This study aimed to investigate management strategies for AD and its relation with corticophobia among HCPs.
METHODS
Dutch general practitioners (GPs), youth healthcare physicians (YHPs), pediatricians, dermatologists, pharmacists, and pharmacy assistants participated in a survey on management strategies and corticophobia. The Topical Corticosteroid Phobia questionnaire for professionals (TOPICOP-P) was used to measure attitudes toward topical corticosteroids (TCSs). Higher scores reflect a more negative attitude.
RESULTS
A total of 407 HCPs (124 GPs, 33 YHPs, 51 pediatricians, 56 dermatologists, 58 pharmacists, and 85 pharmacy assistants) participated. Compared to dermatologists, other HCPs showed greater reluctance to TCS. This difference was highlighted by the finding that half of GPs reported to prescribed only TCS of mild potency for infants with severe AD, while few dermatologists (9%) reported a similar approach. Dermatologists had lowest TOPICOP-P scores (median: 19, IQR: 12-28). GPs and pharmacy assistants had highest scores (GPs median: 36, IQR: 31-44, pharmacy assistants: median: 36, IQR: 31-42). More corticophobia was significantly associated with prescription of a lower TC potency class in prescribing HCPs (B -0.04, 95% CI: -0.07 to 0.01, p = 0.01), and a trend was found between more corticophobia and longer perceived durability of one TCS tube.
CONCLUSIONS
This study shows the differences in management of AD and reluctance toward TCS in HCPs. Furthermore, corticophobia among HCPs and its influence on the selection of TCS potency class and recommendations were demonstrated. To reduce corticophobia and improve care for AD, more education is needed.
引言
各类医疗保健专业人员（HCPs）为特应性皮炎（AD）患者提供护理。尽管这至关重要，但尚未对HCPs的管理策略及其与皮质激素恐惧的关系进行研究。本研究旨在调查HCPs对AD的管理策略及其与皮质激素恐惧的关系。
方法
荷兰全科医生（GPs）、青少年保健医生（YHPs）、儿科医生、皮肤科医生、药剂师和药房助理参与了一项关于管理策略和皮质激素恐惧的调查。使用专业人员外用皮质类固醇恐惧症问卷（TOPICOP-P）来测量对外用皮质类固醇（TCSs）的态度。分数越高反映态度越消极。
结果
共有407名HCPs（124名全科医生、33名青少年保健医生、51名儿科医生、56名皮肤科医生、58名药剂师和85名药房助理）参与。与皮肤科医生相比，其他HCPs对TCS表现出更大的不情愿。这一差异通过以下发现得到凸显：一半的全科医生报告只为患有严重AD的婴儿开具低效的TCS，而很少有皮肤科医生（9%）报告采用类似方法。皮肤科医生的TOPICOP-P分数最低（中位数：19，四分位距：12 - 28）。全科医生和药房助理的分数最高（全科医生中位数：36，四分位距：31 - 44，药房助理：中位数：36，四分位距：31 - 42）。在开处方的HCPs中，更多的皮质激素恐惧与开具较低效的TC类别显著相关（B -0.04，95%置信区间：-0.07至0.01，p = 0.01），并且发现更多的皮质激素恐惧与认为一支TCS管的耐用时间更长之间存在一种趋势。
结论
本研究显示了HCPs在AD管理方面的差异以及对TCS的不情愿。此外，证明了HCPs中的皮质激素恐惧及其对TCS效价类别选择和建议的影响。为了减少皮质激素恐惧并改善对AD的护理，需要更多的教育。
引言
各类医疗保健专业人员（HCPs）为特应性皮炎（AD）患者提供护理。尽管这至关重要，但尚未对HCPs的管理策略及其与皮质激素恐惧的关系进行研究。本研究旨在调查HCPs对AD的管理策略及其与皮质激素恐惧的关系。
方法
荷兰全科医生（GPs）、青少年保健医生（YHPs）、儿科医生、皮肤科医生、药剂师和药房助理参与了一项关于管理策略和皮质激素恐惧的调查。使用专业人员外用皮质类固醇恐惧症问卷（TOPICOP-P）来测量对外用皮质类固醇（TCSs）的态度。分数越高反映态度越消极。
结果
共有407名HCPs（124名全科医生、33名青少年保健医生、51名儿科医生、56名皮肤科医生、58名药剂师和85名药房助理）参与。与皮肤科医生相比，其他HCPs对TCS表现出更大的不情愿。这一差异通过以下发现得到凸显：一半的全科医生报告只为患有严重AD的婴儿开具低效的TCS，而很少有皮肤科医生（9%）报告采用类似方法。皮肤科医生的TOPICOP-P分数最低（中位数：19，四分位距：12 - 28）。全科医生和药房助理的分数最高（全科医生中位数：36，四分位距：31 - 44，药房助理：中位数：36，四分位距：31 - 42）。在开处方的HCPs中，更多的皮质激素恐惧与开具较低效的TC类别显著相关（B -0.04，95%置信区间：-0.07至0.01，p = 0.01），并且发现更多的皮质激素恐惧与认为一支TCS管的耐用时间更长之间存在一种趋势。
结论
本研究显示了HCPs在AD管理方面的差异以及对TCS的不情愿。此外，证明了HCPs中的皮质激素恐惧及其对TCS效价类别选择和建议的影响。为了减少皮质激素恐惧并改善对AD的护理，需要更多的教育。
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