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Prescribing emergency oral steroids in asthma clinics

Rhian Willson1, Sukeshi Makhecha2, Rachel Moore-Crouch1

  • 1Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK.

Archives of Disease in Childhood
|June 13, 2019
PubMed

Insights

Children needing emergency oral corticosteroids (OCS) often show poor adherence to regular inhaled preventer therapies. Assessing adherence is crucial for improving asthma management in pediatric respiratory care.

Area of Science:

  • Pediatric Respiratory Medicine
  • Pharmacological Adherence Research

Background:

  • Acute oral corticosteroids (OCS) are frequently prescribed for pediatric respiratory conditions.
  • Assessing adherence to long-term controller medications is vital for effective disease management.
  • Poor adherence can lead to exacerbations and increased healthcare utilization.

Purpose of the Study:

  • To evaluate adherence to inhaled corticosteroid (ICS) or combination inhaler therapy in children prescribed emergency OCS.
  • To identify if emergency OCS prescription serves as an indicator of poor adherence to preventer medications.

Main Methods:

  • Retrospective review of pediatric patients attending a tertiary respiratory clinic.
  • Analysis of prescription uptake data for ICS or combination inhalers in the 6 months preceding OCS prescription.
  • Assessment of adherence rates based on prescription data.

Main Results:

  • Over 2 years, 25 children received 32 courses of prednisolone (a type of OCS).
  • The median adherence to preventer therapies was 33%.
  • Children with repeated OCS prescriptions demonstrated even lower adherence rates (28%).

Conclusions:

  • Prescribing acute OCS in a routine clinic setting may signal underlying poor adherence to preventer therapies.
  • This finding suggests a potential underestimation of symptom severity by the child or family.
  • Routine assessment of adherence and targeted support are recommended for children with poor adherence to controller medications.

Keywords:
adherenceasthmacorticosteroids

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