The NHS BSA has developed a new metric to help tackle the over-prescription of prednisolone in England.

Developed in collaboration with Guy’s and St Thomas’ NHS Foundation Trust and the Oxford Academic Health Science Network, the new metric looks at patients who have been prescribed prednisolone tablets along with a medicine for asthma or COPD in the last 12 months.

It calculates the total cumulative dose in milligrams for the whole duration of the prescription in order to help clinicians identify and review any patients who may be at risk, as well as potentially offering these at-risk patients an alternative therapy or clinical strategy.

The NHS BSA says this method can also help minimise the chance of including patients taking prednisolone for non-respiratory conditions such as Crohn’s disease and rheumatoid arthritis.

While prednisolone can help treat respiratory illnesses, recent studies show that overprescribing short course steroids can have adverse health consequences such as diabetes, cardiovascular illness and mental health disorders. In 2020 over 35,500 patients were prescribed more than three grams of the drug, which is considered a high dose.

Consultant pharmacist Grainne d’Ancona said: “For the moment, oral corticosteroids still have a role in managing airways disease. However, they must not be mistaken for an innocuous and inevitable consequence of having asthma or COPD.

“Our awareness of the problems associated with them and the availability of effective alternative strategies to achieve disease control, including optimised adherence to preventer inhalers and newer biologic therapies for appropriate patients, mean we can and should reduce patient’s need for them. Facilitating early identification of those most in need of a review is a crucial step on this path.”

Oxford AHSN pharmacy lead Seema Gadhia said: “Being able to identify people on high cumulative doses of oral corticosteroids, and offer alternative treatment management, has the potential to significantly improve outcomes and reduce the risk of steroid related side effects.”

NHS BSA chief data officer Darren Curry said: “A lot of the work we do is around patient safety and to provide the data and access to data which helps to improve patients’ lives. We’ve worked with Oxford AHSN and Guys and Thomas Hospital for the past eight months, collaborating and sharing to bring all of our skills together to help make a difference.”