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National survey conducted among Italian pediatricians examining the therapeutic management of croup.
- Source :
-
Respiratory medicine [Respir Med] 2024 May; Vol. 226, pp. 107587. Date of Electronic Publication: 2024 Mar 24. - Publication Year :
- 2024
-
Abstract
- Objectives: Practice-to-recommendations gaps exist in croup management and have not been critically investigated. This study examined the therapeutic management of croup among a national sample of Italian pediatric providers.<br />Methods: A survey was administered online to a sample of primary care and hospital-based pediatricians. Demographic data, perception regarding disease severity, treatment and knowledge of croup, choices of croup treatment medications, and knowledge of and adherence to treatment recommendations were compared between hospital and primary care pediatricians. Oral corticosteroids alone, oral corticosteroids with or without nebulized epinephrine and nebulized epinephrine plus oral or inhaled corticosteroids were considered the correct management in mild, moderate and severe croup, respectively. The determinants for correct management were examined using multivariate logistic regression analysis.<br />Results: Six hundred forty-nine pediatricians answered at least 50% of the survey questions and were included in the analysis. Providers reported extensive use of inhaled corticosteroids for mild and moderate croup. Recommended treatment for mild, moderate and severe croup was administered in 46/647 (7.1%), 181/645 (28.0%) and 263/643 (40.9%) participants, respectively. Provider's age and knowledge of Westley Croup Score were significant predictors for correct management of mild croup. Being a hospital pediatrician and perception of croup as a clinically relevant condition were significant for moderate croup.<br />Conclusions: Significant differences exist between recommended guidelines and clinical practice in croup management. This study suggests wide variability in both the treatment of croup and clinical decision making strategies among hospital and primary care pediatricians. Addressing this issue could lead to noteworthy clinical and economic benefits.<br />Competing Interests: Declaration of competing interest none.<br /> (Copyright © 2024 Elsevier Ltd. All rights reserved.)
- Subjects :
- Humans
Italy
Male
Female
Surveys and Questionnaires
Administration, Inhalation
Epinephrine administration & dosage
Epinephrine therapeutic use
Practice Patterns, Physicians' statistics & numerical data
Severity of Illness Index
Adult
Administration, Oral
Middle Aged
Nebulizers and Vaporizers
Guideline Adherence statistics & numerical data
Health Knowledge, Attitudes, Practice
Child
Primary Health Care statistics & numerical data
Croup drug therapy
Pediatricians statistics & numerical data
Adrenal Cortex Hormones administration & dosage
Adrenal Cortex Hormones therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1532-3064
- Volume :
- 226
- Database :
- MEDLINE
- Journal :
- Respiratory medicine
- Publication Type :
- Academic Journal
- Accession number :
- 38522591
- Full Text :
- https://doi.org/10.1016/j.rmed.2024.107587