Paediatricians' practices and knowledge of corticosteroids: A national survey

Aim To explore corticosteroid prescription practices and knowledge among paediatricians. Methods The Paediatricians Corticosteroids Survey, a cross-sectional, web-based survey distributed to Israeli paediatricians between February and July 2018. Results Three hundred and forty-nine paediatricians (105 general paediatricians, 207 subspecialists and 37 paediatric endocrinologists) participated. Two hundred and three (58.2%) had >10 years of paediatric clinical experience and treated >60 patients/wk on average, 175/318 (55%) prescribed corticosteroids to >10% of their patients. On knowledge items, 11/266 (4.1%) responded 'not sure' when tapering of steroids is required, 22/268 (8.2%) to what 'stress dose' meant and 27/268 (10.1%) when a stress dose is required. Multivariate linear analysis showed higher scores were associated with training in paediatric endocrinology (beta = 2.271,P = 0.032); medical practice only in a subspecialty (beta = 1.909,P = 0.041) or in both general paediatrics and a subspecialty (beta = 2.023,P = 0.014), compared to general paediatrics alone and medical studies in Israel (beta = 1.059,P = 0.035). Overall, 96.2% thought continued medical education (CME) sessions would be helpful. Conclusion Our findings suggest that despite clinical experience with corticosteroid usage, respondents demonstrated gaps in knowledge for potentially life-threatening situations. Corticosteroid-based CME programs are warranted to improve paediatricians' knowledge and patient management.