The Risks of Overprescribing Asthma, Hay Fever Drugs
Experts within the pharmaceutical sector are warning that medication designed for use in children with conditions of an allergic nature may be being prescribed at too high a dose. A study into the situation was recently undertaken in Scotland, in which it was found that 10+ per cent of the children assessed were simultaneously being provided with corticosteroids, and drugs relating to separate conditions including hay fever. There are risks attached to the consequent build-up in the body of inhalers, nasal sprays and cream taken together, stress the experts – urging that, in response, vigilance is observed by pharmacists and GPs alike.
Asthmatic children frequently also suffer from eczema or hay fever. In those in which two or more conditions co-exist, corticosteroids are the appropriate treatment, which would be provided in inhaled form for asthma, and nasal form for hay fever. Resultantly, the steroids ingested are much higher than would otherwise be the case.
A principal figure involved in the research was the University of Aberdeen’s Dr James McLay – the Department of Medicine and Therapeutics’ Senior Lecturer. Gleaned from 305 GP surgeries across Scotland, Dr McLay examined 345,221 individual children’s records. Within the group of those prescribed asthma-related inhaled corticosteroids on a repeat basis, he found that that one in eleven were additionally being provided a minimum of one further medication within the corticosteroid family for another condition. Additionally, as many as half of the children prescribed with the inhaled/nasal combination could be receiving steroids at too high a rate.
Corticosteroids belong to a family of drugs which aid in reducing inflammation. Medical research in the field has not yet established definitely what happens to children when they are taken excessively, however, some evidence has hinted at a possible reduction in growth/development. In extreme instances, corticosteroids have proved fatal when taken at very high dose levels.
As detailed by Dr McLay: "This research shows that a significant number of children are prescribed more than one corticosteroid preparation for an allergic condition. If a child is prescribed corticosteroid treatment for one condition at the maximum or near the maximum dose, then another steroid prescription would tip them into over-exposure. And in children you can really get some dramatic adverse effects."
Given, he said, the fact that the children concerned would be seen by different doctors for their various conditions, a system of notification needed to be developed that would become active in potential cases of over-prescription. "We therefore recommend that all healthcare professionals or parents under the direction of a healthcare professional check for this issue", he concluded.
According to the Royal College of GPs’ Chair – Professor Mayur Lakhani, the risks attached to corticosteroids were highlighted in a notice issued to GPs in 2006.
The professor detailed how, in the absence of computer-issued alerts (yet), GPs were adopting an increasingly-watchful role. “Sprays seem innocuous, but actually they are potent medicines and extra care is needed”, he said, adding: "There are regular medication reviews that take place as part of the GP contract so every six to 12 months all patients should have an assessment."
"If a patient is alarmed it is worth having a chat with a pharmacist or GP at their next routine appointment”.
Source – Pharmaceutical International’s Health Reporter
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