Clinical Indicator:
Monitoring of side effects in patients receiving systemic corticosteroid therapy at Immunodermatology Clinic
Introduction:
Many patients seen in this subspecialty clinic are treated with systemic corticosteroids. However, there may not be adequate monitoring for side effects as patients on long term systemic corticosteroids (prednisolone ≥5mg/day for at least 3 months) may be at risk of raised blood pressure, blood sugar levels, visual problems and infections.
Objective:
To achieve monitoring of side effects in 80% of patients on Prednisolone ≥5mg/day for at least 3 months seen at the Immunodermatology clinic in NSC.
There are 3 parameters to be monitored:
- Blood pressure, Weight, Glucose
- New onset visual disturbances
- Infective symptoms
Method:
Included for monitoring of side effects:
- Patients seen at the Immunodermatology clinic in NSC and,
- Receiving oral prednisolone at least 5mg/day for more than 3 month
Excluded from monitoring of side effects:
- Patients seen at all other clinics in NSC
- Receiving less than 5mg/day of oral prednisolone
- Receiving oral prednisolone for less than 3 months
- Already on Eye follow up
Interventions were proposed to target specifically at the top few root causes of inadequate monitoring. These interventions were implemented in stages from February 2016 to March 2016, and are currently still in place.
Results:
There has been a significant improvement in monitoring of side effects for patients on systemic steroids since the implementation of the various interventions. The compliance to monitoring is being monitored and recorded via our electronic medical records.
Compliance to Monitoring of side effects in patients on Prednisolone ≥5mg/day
Conclusion:
Patients with side effects from steroid use will be able to have the side effects detected earlier. They will then be referred to the appropriate specialities earlier when abnormalities are detected. Treatment for any cutaneous infections can be started when these conditions are diagnosed during the clinic consult.
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