Risk Alert: Beware dangerous side-effects in chronic asthma treatment

15 January 2010

MDDUS has dealt with a number of recent cases in which doctors have failed to adequately monitor long-term steroid treatment of patients with chronic asthma leading to serious side-effects.

Often claims are the result of failings in practice systems to monitor high-dose oral and/or inhaled steroid treatment in patients with serious and recurring episodes treated by different doctors. Failure to take account of concurrent steroid treatment for other conditions has also lead to potentially damaging side-effects.

Long-term treatment with moderate to high-dose steroids is associated with a number of side-effects in adults including bone demineralisation and osteoporosis, high blood pressure and immune-system suppression leading to an increased chance of infection. In children high-dose steroid treatment has been associated with systemic side-effects including growth failure and adrenal suppression.

The British Thoracic Society and Scottish Intercollegiate Guidelines Network (SIGN) have published guidelines on safe and efficacious treatment and monitoring of patients on inhaled and oral steroids. It is essential to be aware of these and other relevant guidelines when treating patients with moderate to severe asthma.

ACTION: Ensure you have adequate practice systems in place to monitor patients on long-term steroid treatment for asthma. Be aware of relevant guidelines on the treatment of asthma and possible side-effects.

Link: 2008 British Guideline on the Management of Asthma - updated June 2009