OBJECTIVES: Occupational burnout is a common phenomenon among healthcare providers. However, information about burnout in pediatric neurologists managing spinal muscular atrophy (SMA) is limited. Our aim was to assess the presence of burnout and its influence on treatment decisions in SMA care.

METHODS: We conducted a multicenter, non-interventional, cross-sectional, web-based study. Pediatric neurologists involved in SMA care from across Spain answered a survey with demographic and professional characteristics, questions about their standard clinical practice using 11 simulated case-scenarios of SMA type 1 and 2, and a behavioral battery including the Maslach Burnout Inventory - Human Services Survey (MBI-HSS). The primary outcome was therapeutic inertia (TI), defined as the number of simulated scenarios with lack of treatment initiation or escalation when warranted over the total presented cases. A multivariable logistic regression analysis was conducted to determine the association between participants’ characteristics and treatment preferences.

RESULTS: A total of 35 pediatric neurologists completed the study. Mean age (±SD) was 40.6 (9.6) years, 62.9% were women, with a mean experience of 11.5 (9.1) years. Eleven (31.4%) participants had burnout. The mean (SD) TI score was 4.2 (1.7), and 3.29 (1.5) for treatment initiation. Of a total 385 individual responses, TI was observed in 147 (38.2%) of treatment choices. TI scores (mean, [SD]) were higher among participants with burnout compared to their counterpart (4.0 [0.36] vs. 2.96 [0.32], respectively; p=0.05). The multivariable analysis showed that burnout was associated with higher TI scores (β coefficient 1.24, 95%CI 0.12-2.4; p=0.03) after adjustment for age and years of professional experience

CONCLUSIONS: Occupational burnout is associated with increased risk of therapeutic inertia among pediatric neurologists managing patients with SMA. Identifying burnout may be critical for implementing specific intervention strategies to maintain an optimal disease control.