EXPERTS are warning that thousands of asthma patients may be taking potentially dangerous levels of drugs in efforts to control their condition.
Asthma sufferers are prescribed inhaled steroids in increasing doses until the illness is under control. However, a researcher at Aberdeen University has warned that many patients may be taking doses that are too high and that medication should be reviewed regularly.
Long-term use of high doses of inhaled steroids can have serious side-effects, such as an increased risk of brittle bones, cataracts and glaucoma.
In the highest doses, the drugs can suppress the body's production of natural steroids, which can be life-threatening.
Dr Mike Thomas, a clinical research fellow at Aberdeen University, and colleagues assessed the prescribing records of more than 22,000 patients with asthma.
They found that 27 per cent were on high doses of inhaled steroids - more than 800 micrograms a day. One in 30 was said to be on "potentially dangerous" doses of more than 2,000mcg.
Dr Thomas said a third of patients were not receiving other so-called add-on therapies, which might help to control their asthma.
"There has been a change in what is recommended for the management of asthma," he said. "Ten years ago, we started with low doses, and if asthma was not controlled, the dose was raised.
"Over the past five years, it has become apparent that there are problems with the high doses of inhaled steroids. Now the guidelines advise that we should use the lowest dose needed to control the asthma."
Dr Thomas said researchers had been surprised by the level of high-dose inhaled steroids being used. "In some patients, high doses are required, but this is probably much more than is needed," he said.
Dr Thomas said GPs should be auditing the use of inhaled steroids to review asthma prescriptions. "We have to be sure that we are giving patients accurate information so they can make the right decisions," he said.
"Low doses of steroids are safe, but if you don't point out the risks with high doses, there may be a breakdown in trust."
About 390,000 people in Scotland receive treatment for asthma, 197,000 of whom have severe symptoms.
Dr Jim Kennedy, the prescribing spokesman at the Royal College of GPs, said doctors were aware of the asthma guidelines.
He said asthma patients made up a large part of GPs' workload and doctors were giving newer treatments as they became available. "We are aware of the guidance on stepping up and stepping down treatment," he said.
"If you analyse prescribing data, you may over-estimate what is actually being taken on a routine basis. GPs will advise patients when they need to increase their dose and when they can reduce it."
Erica Evans, an asthma nurse specialist at the charity Asthma UK, said: "
Asthma treatments are effective and safe, but they must be used responsibly."
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