Supplementary Material for: Management strategies and corticophobia among healthcare professionals involved in the care for atopic dermatitis: a Dutch survey

Background:
Many 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 (TCS). 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 were more reluctant with TCS as illustrated by the portion (50%) of GPs that reported to prescribe TCS of only mild potency for infants with severe AD, compared to dermatologists (9%). 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 (B -0.04, 95%CI: -0.07-0.01, 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 towards TCS in HCPs. Furthermore, corticophobia among HCPs and its effect on management of AD was confirmed. To reduce corticophobia and improve care for AD, more education is needed.