Preventing Emergency Department Visits and Hospitalizations for Asthma by Use of Oral Corticosteroids at Home: Are We Adhering to National Guidelines?

Abstract

Despite evidence of reduced ED visits and hospitalizations and the recommendations of national and international guidelines, the home use of OCS in managing asthma exacerbations remains unacceptably low. New strategies are needed to ensure home use of OCS as part of written action plans to prevent ED visits and hospitalizations for asthma exacerbations.

Corticosteroid-induced psychiatric disturbances: It is time for pharmacists to take notice

“…3 In asthma, corticosteroids are used to control inflammation by inhibiting synthesis and release of inflammatory mediators, and in this population corticosteroids have been shown to lower hospital admission rates, reduce risk of relapse as well as decrease mortality. 1,6 Corticosteroids use the intracellular receptor mechanism to suppress inflammation and thus offer symptomatic relief and halt progression of inflammatory response. However, the mechanism of action of corticosteroids is far more complex in terms of their broad spectrum of cognitive and psychiatric symptoms.…”

Asthma Flare-up Diary for Young Children to monitor the severity of exacerbations

“…Yet asthma symptoms can persist for several days to weeks, with management occurring largely in the home before, after, or without seeking health care. 2,3 In fact, between 40% and 75% of preschool asthma exacerbations do not result in an acute care visit 4 or use of rescue systemic corticosteroids. [5][6][7] Use of rescue short-acting b 2 -agonists (SABAs) provides useful information, but it hinges on the parental perception of needs and interpretation of symptom severity, which can vary between caregivers, even for the same symptom severity.…”