Awareness of Long-Term Prednisolone Use Among Patients Attending a Respiratory Clinic in Sri Lanka: A Clinical Audit

Background: Prednisolone is recognized as one of the most commonly used, highly effective anti-inflammatory agent. It plays a pivotal role in the management of various disease conditions in pulmonology, such as interstitial lung diseases, sarcoidosis, bronchial asthma, chronic obstructive airway disease, allergic bronchopulmonary aspergillosis and even in some forms of extrapulmonary tuberculosis. However, this medication with great therapeutic importance is not free of risks. Long-term use and use in higher doses are known to cause various systemic adverse effects. Therefore, complying with recommended precautionary strategies is of paramount importance. Objectives: To assess awareness of correct use of prednisolone particularly among long-term, outpatient users. Methodology: A structured interviewer-based questionnaire was used to assess awareness of prednisolone usage in patients attending Central chest clinic, Colombo. Forty-one consecutive patients on long term prednisolone were selected from the clinic. The questionnaire was prepared based on recommendations and guidelines related to proper use of corticosteroids. Data were collected by the principal investigator. Results: This clinical audit highlighted the inadequacy of awareness about side effects and safety practices among patients on prolonged courses of prednisolone. Conclusion: Patients need to be educated more on adverse effects, safety measures and correct use to improve risk/ benefit ratio. Designing a steroid treatment card was identified as a potential method to optimize patient education, monitoring and adverse outcome prevention in long-term steroid therapy. Intended quality improvement will be evaluated by re-auditing the implemented protocol.