S.D. Smith, A. Lee, A. Blaszczynski, G. Fischer
Dr S Smith, Dr A Lee, Professor A Blaszczynski and Assoc
Prof G Fischer equally contributed to the construction of
this review article.
Background: Topical corticosteroids (TCS) are the standard
of care in paediatric atopic dermatitis (pAD). TCS
phobia is commonly cited by parents as a major impediment
to treatment adherence. Parents frequently state that information
provided by pharmacists is a signiﬁcant factor in
Objectives: To assess pharmacists’ beliefs and sources of
information on the safety of TCS in treatment of pAD and
to determine whether their beliefs can be modiﬁed by
Methods: Pharmacists attending a continuing professional
development conference were assessed before and after a
lecture presenting evidence-based information on the use
of TCS in pAD. Responses recorded in real-time by electronic
Results: The mean response rate was 86% of 292 surveyed.
Of responders, 64% recognised that treatment adherence
was a major reason for treatment failure in pAD. The posteducation
session assessment demonstrated a major shift in
attitude compared to the pre-education assessment. As a
result of education the pharmacists would instruct parent/
patients to apply until eczema is clear (92% vs 27% 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 a common side effect dropped from 46% to 7% (p < 0.0001). A belief held by 56% that side-effects from TCS would occur even if used appropriately, dropped to 11% post-education (p < 0.0001). Conclusions: There are signiﬁcant gaps that exist in Australian pharmacists’ knowledge of the use and safety of TCS in pAD which have the potential to contribute to poor treatment compliance. These attitudes appear modiﬁable through targeted, evidence-based education delivered by a dermatologist.