The Asthma Society of Ireland today reveals the results of new research into the dispensing of steroid tablets across Irish retail pharmacies.
The market research (1) is published as colder, damper weather approaches, and residential fuel burning and increased viral infections trigger asthma symptoms and exacerbations. The research, conducted by IQVIA, which used longitudinal retail pharmacy prescription data revealed that in the period 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 that were 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 twelve-month period their asthma may be uncontrolled and they require a medical review. Uncontrolled asthma, if left untreated, can result in serious exacerbation, unscheduled GP visits, hospital admissions or even fatalities.
While steroid tablets are an effective and inexpensive treatment for acute asthma symptoms, asthma should be routinely managed with inhaled steroids that treat the underlying inflammatory disease and are far less potent. A medical review would assess whether the person with asthma is on the right inhaler, receiving the right dosage and that they are taking their inhaler properly.
Steroid tablets are associated with significant adverse side effects and should be prescribed at the lowest effective dose for the shortest possible time. Long-term use can lead to cataracts, glaucoma, hypertension, diabetes, and depression. Even short-term use risks sleep disturbance, reflux, hyperglycaemia, sepsis, and increased risk of infection.
The research, conducted by IQVIA, used longitudinal retail pharmacy prescription data, and was reviewed by the Asthma Society of Ireland’s Medical Advisory Group.
Dr Maitiú Ó Faoláin, Meath-based GP and member of the Asthma Society’s Medical Advisory Group, said, "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.
GP surgeries are busier than ever, and we want to minimise time spent in waiting rooms or, indeed, on hospital trolleys. Ideally, GPs would take a proactive approach to scheduling regular asthma reviews, especially with their most vulnerable asthma patients.”
Eilís Ní Chaithnía, CEO of the Asthma Society, continued, “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”.
The inclusion of asthma in the HSE’s Chronic Disease Management Programme was a substantial 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.”
We encouraging people who are worried about their asthma to contact their GP immediately and request a review.
Remember that your asthma is 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
Find out more about steroid tablets and asthma.
Read more about free Asthma Adviceline and nurse-led WhatsApp messaging service here.
This campaign is supported by AstraZeneca. The Asthma Society of Ireland is solely responsible for its content and related materials.
(1) IQVIA [LRx data, patient numbers] October–November 2022
