Changes in oral corticosteroid use in asthma treatment—A 20‐year Danish nationwide drug utilisation study

Abstract

Oral corticosteroids (OCS) are used in asthma management but can cause serious adverse effects. We aimed to investigate the usage trends in a nationwide asthma cohort in Denmark from 1999 to 2018. Using national registers, we identified young adults (18–45 years) with two or more asthma drug collections within 12 months since the age of 15 years as indicative of active asthma. OCS exposure level was stratified as high use (≥5 mg prednisolone/day/year) and low use (<5 mg/day/year). Lorenz curves were computed to illustrate potential skewness of consumption among the OCS users. We identified 318 950 individuals with a median age of 29 years (IQR 20–38 years) whereof 57% were women. The 1‐year prevalence of OCS users was stable at 4.8% (median, IQR 4.7%–4.8%), but with nearly 40% decrease in high‐users from 0.54% in 1999 to 0.33% in 2018. The median annual exposure decreased from 500 mg/year (1999) to 250 mg/year (2018). We found a substantial skewness in the distribution of OCS usage with 10% of users accounting for almost 50% of all OCS use. The prevalence of OCS users among young adults with active asthma has been relatively stable from 1999 to 2018, but with a decreasing prevalence of high‐users and annual consumption.

Beyond direct costs: individual and societal financial burden of asthma in young adults in a Danish nationwide study

“…Costs related to asthma comorbidity (eg, polyposis and allergies) are not included, which could underestimate the true direct costs of asthma in select subpopulations. Third, the definition of asthma used in the present cohort is based on pharmacy redemption data and uses a widely used definition in Danish pharmacoepidemiology,31 32 yet data on formal diagnoses such as objective asthma testing is unavailable. Fourth, while nationwide cohort, artificial selections in terms of age and treatment criteria have been used, possibly reducing generalisability to other age groups.…”

Socioeconomic status is associated with healthcare seeking behaviour and disease burden in young adults with asthma – A nationwide cohort study

“…Second, the use of prescription data for classifying disease severity assumes administration of redeemed medication doses and the diagnosis of asthma based on ICS use fails to incorporate traditional diagnostic methods such as reversibility testing, leading to some uncertainty regarding accuracy of the asthma diagnosis, yet the method is routinely used in Danish epidemiology. 34 , 35 Third, classification of healthcare contacts assumes correct registration in Statistics Denmark, but as databases used are administrative in nature and proper registration as necessary for reimbursement, correct registration is assumed to be prioritized both in primary and secondary care. Fourth, the inclusion criteria in the present study excludes severely non-adherent and/or SABA-only treated asthma who could be included in the background population controls, yet only 5.6% of secondary care contacts in controls were respiratory, ergo can classification bias argued to be minor.…”

A Prospective Study On Corticosteroids Utilization Pattern In Dermatology Department Of A Tertiary Care Teaching Hospital, Bangalore, India

“…[6] The topical application disadvantages are adrenal suppression, epidermal, and dermal thinning, purpura, striae, steroid induced rosacea, perioral dermatitis, and hypertrichosis. [7,8] Thus, main purpose of using corticosteroids in dermatology is to relieve the patients from signs and symptoms of skin diseases and thus achieve improvements. A study was carried out at a tertiary care teaching hospital in order to evaluate the use of corticosteroids which provided a picture of trends in the usage of corticosteroids in dermatology at that particular set-up.…”