Endocrine Abstracts

Introduction: Steroids are used in an array of conditions, ranging from asthma through to haematological malignancies. When using steroids for prolonged periods patients are at risk of developing adrenal crisis with sudden withdrawal. To allow early recognition and support treatment of adrenal crisis patients prescribed high dose steroids should be issued with an MHRA steroid card. Our aim was to identify how many patients needed a steroid card, amongst those taking high dose steroid medication. Our data showed that 24% of those prescribed high dose steroids (oral, topical, subcutaneous and inhaled) had not been issued with an MHRA card. Therefore, we have implemented change by ensuring that these patients are issued with a steroid alert card to support early detection of a crisis.

Methods: We collected data through using the practice software, SystmOne, to identify patients prescribed steroids. 77 patients were identified as having been prescribed steroids at some point from their medical history.

Results: Out of our total sample (77 patients), 53 of these were actively still taking steroids and so had a repeat prescription for a chronic condition, and therefore were at risk of adrenal crisis. 25/53 patients (47%) had been prescribed a high dose and were identified as needing an MHRA steroid card. Further to this, 6/25 patients on high dose steroids (24%) did not have a steroid card, and so were detected as needing a card to achieve our overall aim.

Conclusion: We have implemented change by ensuring that patients prescribed high dose steroids for prolonged periods are issued with an MHRA steroid card. Utilisation of the MHRA card will enable early recognition and support emergency treatment in the event of adrenal crisis.

References: Society for Endocrinology (2020) Adrenal Crisis Information. Available at: https://www.endocrinology.org/adrenal-crisis (Accessed: 26th June 2023)