Business Services Authority (NHSBSA) and partners have developed a new metric to help prescribers identify patients taking potentially harmful quantities of prednisolone.

The new metric looks at patients in England who have been prescribed prednisolone tablets, as well as an asthma/COPD medication in the last 12 months. It calculates the total cumulative dose, in milligrams, for the whole period. This will help clinicians to identify everyone at risk, and to prioritise those most at risk for review.

Pharmacist Grainne d’Ancona says that alternatives may include optimised adherence to preventer inhalers and newer biologic therapies.

The metric is a joint development between NHSBSA, Guy’s and St Thomas’ NHS Foundation Trust and the Oxford Academic Health Science Network (Oxford AHSN) which is leading the national Accelerated Access Collaborative / AHSN Network severe asthma and asthma biologics programme.

This method also minimises the chance of including patients who are taking prednisolone for non-respiratory conditions, which can include Crohn’s disease and rheumatoid arthritis.

In 2020 alone more than 35,500 people were prescribed over three grams of prednisolone, considered a high dose. Altogether over a million people in England took the drug.

Recent studies have shown that prescribing too many short course steroids could cause health problems such as diabetes, cardiovascular illnesses, mental health disorders, musculoskeletal conditions such as osteoporosis and fractures.

NHSBSA is collaborating with Guy’s and St Thomas’ NHS Foundation Trust and the Oxford Academic Health Science Network (Oxford AHSN) which is leading the national Accelerated Access Collaborative / AHSN Network severe asthma and asthma biologics programme.