Why it matters: Latest BTS/SIGN guidance on the treatment of asthma recommends that patients should be maintained at the lowest possible dose of inhaled corticosteroid. Reduction in inhaled corticosteroid dose should be slow as patients deteriorate at different rates. Reductions should be considered every three months, decreasing the dose by approximately 25–50% each time. 'High-dose' inhaled corticosteroids are listed at step 4 of the guidelines. The latest guidance for treatment of COPD now recommends use of another treatment in preference to inhaled corticosteroids. There is some evidence that inhaled corticosteroids increases the risk of pneumonia. This risk appears to increase with dose.
Description: Prescribing of high dose inhaled corticosteroids compared with prescribing of all inhaled corticosteroids
CCGs are ordered by mean percentile over the past six months. Each chart shows the results for the individual CCG, plus deciles across all CCGs in the NHS in England.