Evaluation of Steroid Utilization in Management of Asthma in a Tertiary Hospital in Northern Nigeria

Abstract

Background: There are concerns about the rational use of corticosteroids in asthma as they are associated with serious adverse drug reactions, abuse and are rarely evaluated in clinical settings.

Objectives: The study set out to evaluate the drug utilization parameters of corticosteroids in the management of chronic asthma in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.

Method: A Retrospective study employing structured data collection form to obtain data from randomly selected folders of 120 asthmatic out-patients in a tertiary health care facility between July 2011 and June 2012. Prescribing, facility and complimentary drug use indicators were analyzed using descriptive and Chi-Square statistics.

Results: Females accounted for 80% of study population, mainly housewives (51.6%). While 59.1% were aged 21-50 years. Mean number of drugs per prescription was 4.46±0.098. Generic prescriptions were 45.5% while antibiotics and injections were 30% and 28.4% respectively. The medications most utilized include inhaled Fluticasone/Salmeterol fixed combination in 71% and inhaled Salbutamol in 77.7% of patients respectively. Oral corticosteroid (prednisolone) was used in 25% of patient. The average cost per prescription was N5080 ($31). There was no significant association between severity of asthma and use of inhalational steroids (Chi-Square P>0.05), in contrast to a statistically significant difference (P=0.01) in use of oral corticosteroids.

Conclusion: Sub maximal utilization of steroids in asthmatics as inhalational therapy was observed. Recommendations on the use of therapy that suit local conditions with respect to cost will promote adherence and ultimately improve rational drug use and outcomes in patients

Key words: Steroid Utilization, Chronic Asthma, Fluticasone/Salmeterol, Salbutamol