Patient perspectives on the use of oral corticosteroids in asthma

Oral corticosteroids (OCS) are used to treat uncontrolled asthma, either as short rescue courses of treatment for severe disease exacerbations, or as long-term maintenance therapy in addition to other controller medications. Although the adverse events (AEs) associated with OCS are well understood by healthcare professionals (HCPs), the patient's perspective may be underappreciated. This review discusses the patient perspective on OCS use.

A PubMed literature review was performed.

Articles were selected to include those primarily containing data on patient perspectives on OCS use in asthma or other airway diseases, including qualitative and quantitative studies. Articles including only clinical data and those primarily focused on another indication were excluded. Additional articles meeting the criteria were permitted based on author knowledge and the bibliographies of systematic reviews on other topics.

A total of 6066 articles were identified from the PubMed search; 111 were assessed more closely for eligibility. Fourteen articles were eventually selected by the reviewers for inclusion and confirmed by all authors. Several key themes were identified: (1) Key AEs were prominently reported by patients (including weight gain, skin thinning, known osteoporosis/osteopenia, and sleep/mood disturbances); (2) Impact of OCS on day-to-day lives; (3) Patient perceptions of OCS; (4) Effect of perceptions on treatment adherence.

HCPs should consider the impact that OCS have on their patients' wellbeing, including short courses. It is essential for HCPs to discuss the short and long-term risks of OCS with patients prior to initiation of treatment and consider alternatives for patients on long-term OCS.