Corticosteroids Use: A survey on the level of knowledge and prescription pattern of doctors in Maiduguri, North-eastern Nigeria

Abstract

Background: Despite the high prescription rates of Corticosteroids (CS), physicians have poor knowledge of the long-term effects and monitoring of CS. Objectives: To evaluate the knowledge of doctors in Maiduguri, Nigeria, on the use, adverse effects, and monitoring of corticosteroids.

Methodology: A cross sectional survey involving 248 consenting doctors practicing in Maiduguri  between 1^st of January and 30^th of March, 2020.

Results: Of the 248 doctors surveyed, 161 completed the survey (response rate of 64.9%). Mean age was 34±5.6 years with 95 (59%) males. Majority (74.5%) had only MBBS and 125 (77.6%) were practicing in a tertiary setting, 43 (26.7%) and 38 (23.6%) were from Medicine and General Outpatient Department respectively. Seventyfour (50.7%) had been practicing for one to five years. All had prescribed CS before. Duration of 2 practice was not associated with frequency of CS prescription (χ² = 24.08, p=0.091). Prednisolone was the most commonly prescribed CS (48.4%) while, the oral route was the preferred mode of prescription by 80 (49.7%) respondents. Seventy-three (45.3%) prescribed CS for allergy, respiratory diseases, and dermatological complaints. Most (67.7%) were not aware of the dosage classification of CS but 99 (61.5%) were aware of guidelines for stopping CS during treatment. Majority (92.5%) were aware of multiple adverse effects of CS with 24.2% reporting Cushingoid changes. Seventy-eight (48.4%) routinely assess patients for adverse effects. Only, 4 (2.5%) and 6 (3.7%) of respondents routinely screen for osteoporosis and tuberculosis respectively. Less than 44% and 22% routinely screen for drug-drug interaction and CS complications respectively.

Conclusion: There is low level of knowledge regarding the use and monitoring of CS in Maiduguri.