The Asthma Society of Ireland has warned that over-use of steroid medication may cause more harm than good.
A study has shown that almost 1 in 5 asthma patients were dispensed multiple courses of steroid tablets within a 12-month period. There are an estimated 450,000 people with the condition in Ireland.
The Asthma Society of Ireland says new research, commissioned by AstraZeneca, into the dispensing of steroid tablets across Irish retail pharmacies, highlights the over reliance on the medication to ease symptoms of asthma.
The study was conducted by IQVIA, an Irish company specialising in analytics and clinical research services to the life sciences industry, using longitudinal retail pharmacy prescription data.
It was further reviewed by the Asthma Society of Ireland's Medical Advisory Group.
The research showed that that between October – November 2022, an average of 258,202 people were dispensed medication licensed for asthma and/or COPD in Ireland.
Within that group, almost 1 in 5 (18%) 45,551 – were prescribed two or more courses of steroid tablets in the previous 12 months.
The findings also revealed that nearly a quarter of asthma patients prescribed more than two courses of steroids tablets within the past year were under the age of 18.
Clinical best practice indicates that where an asthma patient requires multiple courses of steroid tablets within a 12-month period their asthma may be uncontrolled, and they require a medical review.
We need your consent to load this rte-player contentWe use rte-player to manage extra content that can set cookies on your device and collect data about your activity. Please review their details and accept them to load the content.Manage Preferences
GP's say uncontrolled asthma, if left untreated, can result in serious exacerbation of symptoms, unscheduled GP visits, hospital admissions or even fatalities.
"Winter can be particularly challenging for people with asthma because cold air, mould in damp walls, pollutants from fuel-burning, and respiratory viruses can all trigger and worsen symptoms. The first step to staying well with asthma is to take your steroid inhaler as prescribed to calm and control any inflammation in your airways,'' said Dr Maitiú Ó Faoláin, member of the Asthma Society’s Medical Advisory Group.
Steroid tablets are an effective and inexpensive treatment for acute asthma symptoms, however, GPs say they should be routinely managed with inhaled steroids to treat the underlying inflammatory disease.
Long-term use of steroids can lead to cataracts, glaucoma, hypertension, diabetes, and depression. Even short-term use risks sleep disturbance, reflux, hyperglycaemia, sepsis, and increased risk of infection.
'I have a love hate relationship with them'
Emily Smyth was diagnosed with asthma as a young adult and has been hospitalised several times over the past year. Emily was routinely prescribed steroids to ease her symptoms.
''I have a love hate relationship with them [steroids],'' Emily said.
''They do work fast. However, long term, they're very bad for your health but they also have short term effects, your sleeping is affected, they can really affect your mood. You can get quite down on them, a bit irritable my family would say."
Doctors have advised that the first step for anyone with asthma is to take your prescribed steroid inhaler.
If symptoms get worse, you should schedule a medical review with your GP, where the patient is assessed to determine if they are on the right inhaler, receiving the right dosage and that they are taking their inhaler properly.
The Asthma Society also offers free advice and has a team of expert nurses ready to provide free advice and support in between visits to your clinician.
"Earlier this year, a survey we conducted among our members indicated alarming rates of symptoms, like night waking and limited activity, which signify poor asthma control among the patient population. This new market research, commissioned by AstraZeneca, has prompted the Society to again speak up about the risks of uncontrolled asthma and call for proactive and standardised care of people with asthma," said Eilís Ní Chaithnía, CEO of the Asthma Society.
The Asthma society said the inclusion of asthma in the HSE’s Chronic Disease Management Programme is a big step forward in the way asthma is treated in primary care.
''It is now time to expand the programme to tackle the persistently high rates of poorly controlled asthma in Ireland and our overreliance on steroid tablets in response to that challenge," Ms Ní Chaithnía said.
The Asthma Society is encouraging people who are worried about their asthma to contact their GP immediately and request a review.
Asthma is deemed to be uncontrolled if:
● You often wheeze, cough or are short of breath
● You often need to use your reliever inhaler
● Your activity is limited by your asthma
● Your sleep is disrupted by your asthma
● You have been hospitalised with your asthma in the past year
● You have been repeatedly prescribed steroid tablets for your asthma in a 12-month period
