title: Pharmacists' knowledge about use of topical corticosteroids in atopic dermatitis: Pre and post continuing professional development education.
abstract: OBJECTIVE
  Topical corticosteroids (TCS) are the standard of care in paediatric atopic dermatitis (pAD). Parents commonly cite TCS phobia as a major impediment to treatment adherence. Misinformation on TCS side-effects can impact on perceptions of TCS safety. We aimed to assess pharmacists' beliefs and information on the safety of TCS in pAD treatment and determine whether their beliefs could be modified.
  
  
  METHODS
  Australian pharmacists attending a continuing professional development conference were assessed before and after an evidence-based lecture on the use of TCS in pAD. Responses were recorded in real time on electronic keypads.
  
  
  RESULTS
  The mean response rate was 86% of the 292 surveyed. Of responders, 64% recognised that treatment non-adherence was a major reason for treatment failure in pAD. The post-education session assessment demonstrated a major attitude shift compared to the pre-education assessment. After education, pharmacists would instruct parents/patients to apply TCS until the eczema is clear (27 vs 92% pre and post-education, P < 0.0001). The proportion that would instruct patients to use TCS sparingly dropped from 54 to 8% (P < 0.0001). The belief that cutaneous atrophy was the commonest side-effect dropped from 46 to 7% (P < 0.0001). The belief that side-effects from TCS would occur, even if used appropriately, dropped from 56 to 11% post-education (P < 0.0001).
  
  
  CONCLUSIONS
  The significant knowledge gaps about the use and safety of TCS in pAD in Australian pharmacists and their advice to patients potentially contributes to poor treatment concordance. These attitudes appear modifiable through targeted, evidence-based education delivered by a dermatologist.
authors.affiliation: Dermatology and Skin Cancer Centre, Gosford, New South Wales, Australia.|Department of Dermatology, Royal North Shore Hospital, Sydney, New South Wales, Australia.|Northern Clinical School, Sydney University, Sydney, New South Wales, Australia.
authors.forename: Saxon D
authors.initials: SD
authors.lastname: Smith
authors.affiliation: Department of Dermatology, Royal North Shore Hospital, Sydney, New South Wales, Australia.|Northern Clinical School, Sydney University, Sydney, New South Wales, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lee
authors.affiliation: School of Psychology, Sydney University, Sydney, New South Wales, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Blaszczynski
authors.affiliation: Department of Dermatology, Royal North Shore Hospital, Sydney, New South Wales, Australia.|Northern Clinical School, Sydney University, Sydney, New South Wales, Australia.
authors.forename: Gayle
authors.initials: G
authors.lastname: Fischer
mesh_terms: D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000188:drug therapy*; D003879:Dermatologic Agents / Q000627:therapeutic use; D004513:Education, Pharmacy, Continuing; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010595:Pharmacists / Q000706:statistics & numerical data; D011361:Professional Competence; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones; D003879:Dermatologic Agents
keywords: adherence; corticosteroid phobia; knowledge; pharmacist; topical corticosteroid