[Prednisolone-dependent asthma patients--often under-treated in ambulatory care? Results of a retrospective study]

A retrospective descriptive analysis of 140 asthmatic patients, classified in our hospital as corticosteroid dependent and treated in outpatients departments showed, that 63% received slow release theophylline (SRT). 33% of them were within the therapeutic dose range, 44% did tolerate a further dose increase of SRT and 23% showed signs of intoxication which could be reduced by decreasing the dose. 12% of all patients were not on oral or inhaled corticosteroids at all. Only 52% received a combined antiasthmatic treatment including corticosteroids and both slow release theophylline and beta-agonists. This percentage was reduced to 18% if secretolytics are counted as a part of combination therapy. During hospital treatment it became evident that actually only 3% of all patients did not tolerate Theophylline retard due to side effects. In hospital 94% of all 140 patients received combined treatment (SRT, beta-agonists and corticosteroids). All of them showed a clear-cut improvement of major asthma symptoms (PEF monitoring, symptom scores, consumption of additional bronchodilators). It is concluded, that steroid dependent asthmatic out-patients are often undertreated: a minor part does not receive steroids at all; about one half does not receive drug therapy combined with bronchodilators; 67 per cent of the patients, who receive SRT (about 2/3 of the total number) is not under optimal theophylline dose regimen.