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You are here: Home / Resources / SystmOne Resource Centre / Medicine Management / Safe Prescribing of Corticosteroids / Steroids

Safe Prescribing of Corticosteroids / Steroids

The following CDRC resources are available to support safe Corticosteroid/ Steroid Prescribing.

Steroid Template

How to Access:

In the lower left hand corner use the search bar, type in ‘Steroids’ and select the following template:

Alternatively, press F12 and search for ‘Steroids’, this will open the aforementioned template.

Machine generated alternative text:
Home Initiation Gastroprotection 
Corticosteroids 
Monitoring Requirements 
All Scripts 
OraljPR Issues 
Jan 2020 
2g,lan 2020 
Height 
Oral Potency ICS Scripts ICS Potency Topical Scripts Topical Potency 
Nasal Scripts 
Injections 
O'E- systolic 130 
O'E- Diastolic 70 
Test 
Height for children 
Hbalc 
Steroid dose 
pred 5mg od 
Oral steroids stopped 
Period 
t least annual 
t least annual 
nnual 
t least annual 
1 7gm 
Haemoglobin Alc lev •g mnm 
Serum potassium 41 m 
Last Recorded Steroid Dose 
03 Jan 2020 
30 Oct 2020 
30 Oct 2020 
Steroid Monitorina - CKS 
Core Data Entry 
Child Growth Chans 
Medication Timeline 
Last 3 Steroid Issues 
All GlucocoNicoids In Last 2 Years 
24 Jun 2021 
Steroid therapy 
Notes 
pred 5mg od 
02 May 201 g STCI steroid treatment card 
CONSIDER DISCUSSING STEROID TREATMENT CARD 
Launch the Steroid Treatment Card protocol 
Prednisolone 
one 1 
Prednisolone 
one 1 
Prednisolone 1 
16 dun 2021 
07 dui 2021 
30 dun 2021 
ConfirmAssue Steroid Treatment Card 
Consider Gastroprotection 
Current Gastroprotection 
Omeprazole 40mg gastro-resistant capsules 07 Jul 2021 
LIKELYto need steroid emergency card 
!! NO record of Steroid Emergency Card Provision !! 
LIKELYto need sick day rules 
!! NO record of Sick Day Rules Provision !! 
Recorded as osteoporotic 
21 dui 2014 
Bone densitometry 
ITO be caps 
Steroid Emergency Card Sick Day Rules 
Show All Conicosteroid Issues 
Steroid use 
Steroid Checklist 
Entered by 
Finished by 
10 Oct 201 g WHO FRAX 10 year osteoporotic fracture probability score 
10 Oct 201 g WHO FRAX 10 year hip fracture probability score with BMO 
15g% 
06 May 2021 12 lg 
FORBES, Gareth (Dr) (General Medical Practitioner) 
FORBES, Gareth (Dr) (General Medical Practitioner) [06 May 2021 12 19 
Expand 
Long Term or Frequent Corticosteroid Use 
Indication for steroid 
Date Stalled 
Current Supervising Team 
Polymyalgia rheumatica 
April 201 4 
Leadgate Surgery

This template has three columns:

Data Entry / Links to other templates/tools Relevant information from the record Links to expanded information 
Monitoring requirements for oral steroids Most recent information about monitoring Link to CKS guidance on monitoring Link to Core Data template to record height/weight etc. Link to child growth charts Medication Timeline Link to view showing all steroid issues in the last 2 years (all forms – e.g., oral, topical, nasal etc.) 
Space to record current oral steroid dose Most recently recorded oral steroid dose Last three oral steroid issues  – helps to look at concordance, frequency of use 
Button to record that steroid treatment card has been issued Most recent record of steroid treatment care issue/discussion Warning will be displayed if STC needs to be considered  
Link to Steroid Emergency Card and Sick Day Rules information Estimation of whether SEC or SDR are needed and whether these have been provided, may need renewal  
 Information about bone health  
Button to run oral steroid checklist Latest steroid checklist information Button to expand the latest information 
Steroid Emergency Cards and Sick Day Rules

This section covers three main areas:

  • Identifying people who need SEC or SDR
  • Checking Eligibility For Steroid Emergency Card / Sick Day Rules 
  • Providing Steroid Emergency Card / Sick Day Rules 

Identifying People who need Steroid Emergency Cards (SEC) or Sick Day Rules (SDR)

  1. The following reports, in the CDRC Quality > Endocrine folder, will identify people who may need SEC and/or SDR. 
? Conicosteroid Safety 1 
Consider Gastroprotection # 
OCS Groups (1464) 
? Conicosteroid Safety 2 
Consider STC Information # 
OCS aualty (9129) 
? Corticosteroid Safety 3M SEC and SDR highly likely to be needed # 
Admission (8) 
? Corticosteroid Safety SEC and SDR highly likely to be needed - may need renewal # 
? Corticosteroid Safety 3 2 SEC and SDR may be needed # 
Cancer (30) 
? Corticosteroid Safety 3 21 SEC and SDR may be needed- may need renewal # 
Cardiovascular (922) 
? Corticosteroid Safety 3 3 SEC highly likely to be needed # 
Decision support (S) 
? Corticosteroid Safety 3 31 SEC highly likely to be needed- may need renewal # 
Dermatology (I S) 
? Corticosteroid Safety 3 4 SEC may be needed # 
? Corticosteroid Safety 3 41 SEC may need renewal* 
Diabetes GR (689) 
Conicosteroids - Risk factors for bleeding 
Drugs requiring montoring (1069) 
Conicosteroids - Risk factors for bleeding 
ENT (7) 
Conicosteroids - Risk factors for bleeding 
docrine (90) 
Conicosteroids - Risk factors for bleeding 
Conicosteroids Safety- Any Issues # 
Gastroenterology (90) 
Conicosteroids Safetv- Consider Providina STC Information - not done in last 11m #
ReportPatientsAction 
? Corticosteroid Safety 3.1People who are highly likely to need SEC and SDR who haven’t already been given both Review record and issue as appropriate 
? Corticosteroid Safety 3.2People who may need SEC and SDR who haven’t already been given both Review record and check that patient is eligible for SEC and SDR +/- issue them 
? Corticosteroid Safety 3.3People who are highly likely to need SEC only who haven’t already been one Review record and issue as appropriate 
? Corticosteroid Safety 3.4People who may need SEC only who haven’t already been given one Review record and check that patient is eligible for SEC +/- issue 

The x.x1 searches identify the same people in the searches above who haven’t had a record of SEC/SDR for at least 13 months – consider renewing the information for these patients. 

  1. The Steroid template will show a warning about need for and provision of SEC and SDR. 
Steroid Emergency Card Sick Day Rules 
Show All Conicosteroid Issues 
LIKELYto need steroid emergency card 
!! NO record of Steroid Emergency Card Provision 
LIKELYto need sick day rules 
!! NO record of Sick Day Rules Provision !! 
Recorded as osteoporotic
  1. The Medication Review Tool template will show a warning. NB. this template will be launched automatically when a medication review is recorded on the repeat template screen (if this has been enabled at your unit). 
Med Rev 
Safetf Tools 
Consider Medication Stan Checklists NO TEARS 
Current Repeats 
Omeprazole 40mg gastro-resistant capsules 
Paracetamol 500mg tablets 
Zerobase 11% cream Thornton & Ross Ltd) 
Plan 
Medication Timeline 
New Acute 
New Repeat 
Expand this box > 
Medication Concordance 
Medication Side Effects 
Prescribing Safety Tools 
Salbutamol 100micrograms/dose inhaler CFC free 
Invita 03 800unit capsules (Consilient Health Ltd) 
Prednisolone 5mg tablets 
Alendronic acid 70mg tablets 
Ferrous fumarate 21 Omg tablets 
Incruse Ellipta 55micrograms/dose dry powder inhaler (GlaxoSmithKline 
Prednisolone 1 mg tablets 
Doxazosin 2mg tablets 
Recent Acutes 
07 Jul 2021 
18 May 2021 
21 Aug 2020 
18 May 2021 
07 Jul 2021 
07 Jul 2021 
18 May 2021 
07 Jul 2021 
18 ,lun 2021 
07 Jul 2021 
07 Jul 2021 
1 To be taken 
ONE OR MO 
Apply to skin 
2 PUFFS FOU 
one daily 
one daily 
take one weekly 
To be taken Tw 
inhale 1 dose 
one daily 
take one daily 
IOApr2014 
Not Asked 
Drug compliance good 
Drugs Requiring Montoring 
Consider Medication Stans/Switches 
Medication Checklists 
Medication Review 
Structured medication review 
Medication review declined 
!! NO record of Steroid Emergency Card Provision !! MAYBE NEEDED 
NO record of steroid SickD Rules MAY BE NEEDED 
! BP due ! 
! CONSIDER OFFERING LIPID LOWERING ! 
On corticosteroids 
On steroids 
24 Jun 2021 Medication review done 
Earliest Repeat Template Review Date: 26 Nov 2021 
NO record of structured medication review 
14 capsule 
100 tablet 
500 gram 
200 dose 
7 capsule 
7 tablet 
4 tablet 
M4 tablet 
30 dose 
7 tablet 
7 tablet 
Expand 
Expand 
Expand 
Expand 
Expand 
Expand
  1. The LTC Master template will show a warning so SEC/SDR can be discussed during LTC reviews.
Core Data Entry 
aronchiectasis 
46 copo 
Pulm Fibrosis 
Hean Failure 
BP Hypertension 
PAD OCS 
Stroke Dcs 
Diabetes 
High Risk of DM 
Hypothyroidism 
NAFLD 
Epilepsy 
Dementia 
a Mental Heath 
C Palliative Care 
Is a Carer 
Check ESR 
Check CRP 
Check LipidsA_FTs 
if would consider stati 
Check Hba lc 
Check BP 
Check ACR 
Tests Needed (Generic) 
Year of Care 
!! NO record of Steroid Emergency Card Provi* 
NO record of steroid Sick Day Rules MAYE 
! CONSIDER OFFERING LIPID LOWERING ! 
Potential Interventions 
eate new Long Term Condtion Review done task
  1. Relevant LTC review templates will display SEC/SDR warnings – e.g. asthma. 
Asthma core Data 
Asthma Control Test 
Record Peak Flow 
Predicted Peak Flow Calculator 
Steroid SafetymAontoring 
Child Growth Chaffs 
NICE Pathway 
Asthma - On QoF register 
Asthma Control Test Not Recorded 
OOF Annual Review - NOT ACHIEVED 
05 Jun 2020 
Peak expiratory flow rate 
350 Limin 
Asthma trigger(s) 
Show patient's growth on WYO growth chans 
og Nov 2007 Predicted peak expiratory flow rate using EN 1 3826 l/min 
HAS record of exacerbation in the last 24 months 
!! NO record of Steroid Emergency Card Provision !! MAYBE NEEDED 
NO record of steroid Sick Day Rules MAYBE NEEDED 
ICS - Like MODERATEHGH dose 
27 Dec 2012 Asthma trigger 
Expand 
Expand 
Expand 
Expand 
Steroid Issuæ 
Expand 
Notes 
dust pets
  1. If a medication is started that suggests the patient may need SEC or SDR a prompt will be displayed. 
Question 
This patient may need a steroid emergency card and sick day rules informatiom 
Qpen Steroid 
Close 
Pause

The Steroid template can be opened to check the requirements and to issue the SEC/SDR. 


Checking Eligibility for Steroid Emergency Card / Sick Day Rules

The guidance for who needs SEC and SDR is quite complex.  The Steroid template will help to check eligibility. 

The home page gives an estimate of the requirements. 

Steroid Emergency Card Sick Day Rules 
Show All Conicosteroid Issues 
CONSIDER the need for steroid emergency card 
!! NO record of Steroid Emergency Card Provision !! 
CONSIDER the need for sick day rules 
!! NO record of Sick Day Rules Provision !!

Click on Show All Corticosteroids to display all corticosteroids issued in the last 2 years. 

Home Initiation Gastroprotection All Scripts OraljPR Issues Oral Potency ICS Scripts ICS Potency Topical Scripts Topical Potency Nasal Scripts 
All Glucocorticoid Prescri tions In Last 2 Years 
Guidance on Emergency Card and Sick Day Rules 
Hydrocortisone cream 
Fluticasone 250micrograms/dose inhaler CFC free 
Fluticasone 250micrograms/dose inhaler CFC free 
Sereflo 25micrograms/dose / 250micrograms/dose inhaler (Ciplu inhale 2 doses twice daily 
Hydrocortisone ointment 
Hydrocortisone 1% ointment 
Fluticasone 250micrograms/dose inhaler CFC free 
Sereflo 25micrograms/dose 250micrograms/dose inhaler (Ciplu inhale 2 doses twice daily 
Sereflo 25micrograms/dose / 250micrograms/dose inhaler (Ciplu inhale 2 doses twice daily 
Flixotide 250micrograms/dose Evohaler (GlaxoSmithKline LIK Ltd) 
Hydrocortisone ointment 
Hydrocortisone cream 
Sereflo 25micrograms/dose / 250micrograms/dose inhaler (Ciplu inhale 2 doses twice daily 
Flixotide 250micrograms/dose Evohaler (GlaxoSmithKline LIK Ltd) 
Flixotide 250micrograms/dose Evohaler (GlaxoSmithKline LIK Ltd) 
Sereflo 25micrograms/dose / 250micrograms/dose inhaler (Ciplu inhale 2 doses twice daily 
Prednisolone 5mg tablets 
Prednisolone 5mg tablets 
Prednisolone 5mg tablets 
Sereflo 25micrograms/dose / 250micrograms/dose inhaler (Ciplu inhale 2 doses twice daily 
Prednisolone 5mg tablets 
Flixotide 250micrograms/dose Evohaler (GlaxoSmithKline LIK Ltd) 
Sereflo 25micrograms/dose / 250micrograms/dose inhaler (Ciplu inhale 2 doses twice daily 
Prednisolone 5mg tablets 
Flixotide 250micrograms/dose Evohaler (GlaxoSmithKline LIK Ltd) 
Sereflo 25micrograms/dose 250micrograms/dose inhaler (Ciplu inhale 2 doses twice daily 
Apply thinly to the affected area(s 
inhale 1 doses twice daily in adrI 
inhale 1 doses twice daily in adl 
apply sparingly twice daily for a 
Apply thinly to the affected area(s 
inhale 1 doses twice daily in adl 
inhale 1 doses twice daily in adrI 
apply sparingly twice daily for a 
apply twice daily 
inhale 1 doses twice daily in adl 
inhale 1 doses twice daily in adl 
8 daily for 5 days 
8 daily for 5 days 
8 daily for 5 days then reducing 
8 daily for 5 days then reducing 
inhale 1 doses twice daily in adl 
8 daily 
inhale 1 doses twice daily in adl 
dun 2020 
27 dui 2020 
21 Aug 2020 
21 Aug 2020 
21 Aug 2020 
02 sep 2020 
21 sep 2020 
21 sep 2020 
lg Oct 2020 
lg Oct 2020 
lg Oct 2020 
28 Oct 2020 
18 Nov 2020 
18 Nov 2020 
17 Dec 2020 
17 2020 
21 Dec 2020 
30 Dec 2020 
06 dan 2021 
13 dan 2021 
05 Feb 2021 
11 Feb 2021 
11 Feb 2021 
1'? Feb 2021 
11 Mar 2021 
11 Mar 2021 
Injections 
Oral Strength 
ICS Strength 
Topical Strength

Guidance on Emergency Card and Sick Day Rules links to a page which shows the guidance. The ‘Strength’ links take the user to guidance about relative strengths of different steroid preparations which are needed to interpret the guidance (examples below). 

Show All Conicosteroid Issues 
Steroid Emergency Card Needed if: 
courses of high dose oral steroids (1) within last 12m and for 12m after 
topping 
egular oral prednisolone (or equiv) (2) 
intra-articular/intramuscular steroid injections within the last 1 2m and 
or 12m after stopping 
ntra-atcular/intramuscular steroids in last 12m and current steroid by any 
ther route 
exametasone for -10 days OR as pan of repeated chemotherapy 
igh dose ICS (3) and for 12m after stopping 
oderate dose ICS (3) and any oral, nasal, 141M steroids or potent'very 
otent topical 
opical high-dose week) potent or very potent steroids (4) used 
cross a large area for or factors increasing absorption assessed on 
case by case basis, and for 12m after stopping 
otent or very potent topical steroids (4) for the rectal or genital areas at high 
ose (>30g per month) for and for 12m after stopping 
Emergency Card Needed 
es 
es 
Sick Day Rules Needed 
es (if courses oral steroids in 6m
Machine generated alternative text:
Inhaled Steroid Dose Equivalence 
All dosages are daily 
Right Breathe Website 
Adutts (17Y+) 
eclometasone 
lenil, Soprobec, Easyhaler 
VAR, Kelhale, Fostair, Trimbow 
udesonide 
asyhaler, Pulmicorl, Duoresp, Fobumix, Symbicorl 
iclesonide 
Ivesco 
luticasone propionate 
lixotide, Aloflute, Airflusal, Combisal, Flutiform, 
usacomb, Sereflo, Seretide, Sirdupla, Stalpex 
luticasone furoate 
elvar, Trelegy 
ometasone 
smanex 
Children (5-1 ly+) 
eclometasone 
lenil, Soprobec, Easyhaler 
VAR, Kelhale, Fostair, Trimbow 
udesonide 
asyhaler, Pulmicorl, Duoresp, Fobumix, Symbicorl 
iclesonide 
Ivesco 
luticasone propionate 
lixotide, Aloflute, Aifflusal, Combisal, Flutiform, 
usacomb, Sereflo, Seretide, Sirdupla, Stalpex 
ow dose 
Show All Conicosteroid Issues Show ICS Issues 
oderate dose 
00-500mcg over 2 doses 
00-200mcg over 2 doses 
00-400mcg over 1-2 doses 
0-1 60mcg once daily 
00-250mcg over 2 doses 
00mcg once daily 
aediatric low dose 
00-200mcg over 2 doses 
00mcg over 2 doses 
00-200mcg in 1-2 doses 
Omcg once daily 
00mcg over 2 doses 
00-1 000mcg over 2 doses 
00-400mcg over 2 doses 
00-800mcg in 1-2 doses 
40-320mcg over 1-2 doses 
00-500mcg over 2 doses 
00mcg once daily 
00mcg over 2 doses 
aediatric moderate dose 
00-400mcg 
over 2 dosess 
50-200mcg 
over 2 doses 
00-400mcg 
over 2 doses 
60mcg in 1-2 doses 
50-200mcg 
over 2 doses 
igh dose 
200-2000mcg over 2 doses 
00-800mcg over 2 doses 
000-1 600mcg over 2 doses 
00-640mcg over 2 doses 
00-1 000mcg over 2 doses 
00mcg once daily 
p to 800mcg over 2 doses 
aediatric high dose 
00-800mcg over 2 doses 
00-400mcg over 2 dosess 
00-800mcg over 2 doses 
40-320mcg over 2 doses 
50-400mcg over 2 doses 
For children 12-1 6y take into consideration disease severity and patient's size

Providing Steroid Emergency Card / Sick Day Rules 

Steroid Emergency Card Sick Day Rules 
Show All Conicosteroid Issues 
CONSIDER the need for steroid emergency card 
!! NO record of Steroid Emergency Card Provision !! 
CONSIDER the need for sick day rules 
!! NO record of Sick Day Rules Provision !!

Click the Steroid Emergency Card / Sick Day Rules button to open the patient information template. 

Machine generated alternative text:
Steroids 
Patient Information - Steroids 
ource 
hsuk 
hsuk 
atientinfo 
ndocrinology Soc 
ndocrinology Soc 
Create Steroid Emergency Card 
opical steroids 
ps:/'Www.nhs.uk/conditionsmop 
cal-steroids/ 
ral steroids 
ps:/'Www.nhs.uk/conditions/ste 
oid-tablets/ 
asal steroids 
ps:/'batient.infomreatment-medi 
ation/steroid"teroid-nasal-spra 
teroid Emergency Carl 
ps:/'Www.endocrinology.orgin 
diaß873Steroid-card.pdf 
ick Day Rules 
rl.cafe/-02689s 
rint Version 
HS.UK Topical Steroids 
HS.uk Oral Steroids 
atient.info Nasal Steroids 
ick Day Rules 
Show All PIL Information 
otes 
an be ordered from PCSE 
Patient HasGven Steroid Emergency Card 
Patient HasGiven Steroid Sick Day Rules 
Comms Annexe 
Advice to read information

From the table the SEC/SDR can be printed in the surgery or the link can be sent to the patient by SMS/email, using the Communication Annexe 

A patient specific SEC can be created within S1 using the Create Steroid Emergency Card button. This will print to be cut out to credit card size (works best with a colour printer). 

Steroid Emergency Card 
(Adult) 
NHS 
IMPORTANT MEDICAL INFORMATION FOR HEALTHCARE STAFF 
a It and 
aisis 
mt da ity id Owapy "th a of stemid 
Name mg 
VHS Number cns 7674 
Date of Birth 
Why steroid p rescribed 
calling 999M 111, this is a likely 
nsufficieruy/AddimVAddißnian aisis AND describe 
»mptoms (vomiting. dehydration, injury/shod), 
of "'sis 
1) Immediate IWmg Hydrocortisone or i.m. injection. 
by 24 hr continm i.v_ of 2Wmg 
in Glm 5% OR 50ng i.v. 
in. gds (100mg if merely Obese). 
2) Rapid rehydration with Sodium Chloride 0.9%. 
3) Liaise with endocrinology team. 
Sean h for further in formation or Sea

Once the patient has been provided with the relevant information, click the Patient Has/Given SEC/SDRs buttons as appropriate. 

Steroid Monitoring

Monitoring of steroids is integrated into the Drug Requiring Monitoring System and the associated reports. 

Patient with a corticosteroid on repeat (and at least 3 issues in the last 12 months) will be flagged if they have not had BP, U+E, Hba1c (adults) and height (children). 

Affected patients will have the ‘monitoring overdue’ exclamation mark icon: 

OCS On Drug Requiring Monitoring 
MONITORING OVERDUE

Further details will be shown on the Drugs Requiring Monitoring template (which can be launched by clicking the icon)  ……. 

Home Atomoxetine Apomorphine Azathioprine Ciclosporin 
Drugs Requiring Monitoring 
Hydroxycarbamide 
Hydroxychloroquine 
Lenunomide LiraglutidejEkenatide 
Current DRM Repeats 
On corticosteroids 
On steroids 
! BP due ! 
Lithium 
Mercaptopurine 
Cardiovascular System 
Amiodarone 
Dronedarone 
ACEi/A2Ra Renin 
Digoxin 
Thiazides and related 
Spironolactone 
Eplerenone 
Loop Diuretics 
Action 
DOACs 
Central Nervous System 
Antipsychotics 
Anticonvulsants 
Apomorphine 
Atomoxetine 
Lithium 
Melatonin 
Methylphenidate 
Modafinil 
Psychotropic 
Immunosuppressants 
Azathioprine 
Ciclosporin 
Hydroxycarbamide 
Methotrexate 
Mercaptopurine 
Mycophenolate 
Steroids 
Endocrine System 
Cinacalcet

…… the Medication Review Tool  template…….. 

iication Concordance 
lication Side Effects 
10 Apr 2014 Drug compliance good 
Enter Medication Concordance notes 
!! NO record of Steroid Emergency Card Provision !! MAYBE NEEDED 
*scribing Safety Tools 
NO record of steroid SickD Rules MAY BE NEEDED 
! BP due ! 
Drugs Requiring Montoring 
! CONSIDER OFFERING LIPID LOWERING ! 
insider Medication Stans/Switches 
On corticosteroids 
ædication Checklists 
On steroids

….and the LTC Master template. 

Core Data Entry 
aronchiectasis 
46 copo 
Pulm Fibrosis 
Hean Failure 
BP Hypertension 
PAD OCS 
Year of Care 
Diabetes 
High Risk of DM 
Hypothyroidism 
NAFLD 
Epilepsy 
Dementia 
a Mental Heath 
C Palliative Care 
Fraity 
Is a Carer 
Check ESR 
Check CRP 
Check LipidsA_FTs 
if would consider stati 
Check Hba lc 
Check BP 
Check ACR 
!! NO record of Steroid Emergency Card Provi* 
NO record of steroid Sick Day Rules MAYE 
! CONSIDER OFFERING LIPID LOWERING !
Steroid Gastroprotection

From the Steroid  template the Gastroprotection template can be accessed. Guidance and relevant information from the record is shown (such as other drugs that can affect GI bleeding, smoking and alcohol consumption). 

Gastroprotection Anticoagulants 
Corticosteroids 
Antiplatelets Corticosteroids NSAlDs 
CKS Guidance 
Conicosteroids do not greatly increase the risk of peptic ulceratiom PPIs are not routinely 
indicated for prophylaxis of peptic ulceration in people using oral corticosteroids 
Consider PPI for gastrointestinal protection in people at high risk of gastrointestinal 
bleeding or dyspepsia 
Risk factors for gastrointestinal adverse ar4 
• History of gastroduodenal ulcer, gastrointestinal bleeding, or gastroduodenal perforatiom 
• Older ag4 
• Concomitant use of drugs that are known to increase the risk of gastrointestinal bleeding, 
• nonsteroidal anti-inflammatory drugs (for example aspirin and ibuprofen) and 
anticoagulants 
• Serious comorbidity, such as advanced cancer 
Corticosteroid Gastroprotection Information 
Omeprazole 40mg 07 
Prednisolone 5mg tm 07 7t 
Prednisolone Img tm 07 7 t 
! >65yo ! Higher risk of Gl Bleed 
Ex smoker 
Alcohol intake 
0 Unitsmeek 
23 Jun 2020

The following report, found in the CDRC Quality > Endocrine folder, identifies patients taking corticosteroids with higher risk of GI bleeding who are not currently prescribed gastroprotection. 

OCS aualty (9131) 
Admission (8) 
Cancer (30) 
Cardiovascular (922) 
Decision support (S) 
Dermatology (I S) 
Diabetes GR (689) 
Drugs requiring montoring (1069) 
ENT (7) 
Endocrine (91) 
Gastroenterology (90) 
x 
Name 
? Concordance Alert Thyroid Hormone AG (repeat, not issued in the last 3m) # 
? Corticosteroid Safe 1: Consider Gastro rotection# 
? Conicosteroid Safety 2: Consider STC Information # 
? Conicosteroid Safety 3M SEC and SDR highly likely to be needed # 
? Conicosteroid Safety SEC and SDR highly likely to be needed - may need renew 
? Conicosteroid Safety 31 SEC and SDR may be needed # 
? Conicosteroid Safety 311 SEC and SDR may be needed- may need renewal # 
? Conicosteroid Safety 3G SEC highly likely to be needed # 
? Conicosteroid Safety 39.1 SEC highly likely to be needed - may need renewal # 
? Conicosteroid Safety 34 SEC may be needed # 
? Conicosteroid Safety 341 SEC may need renewal #

Affected patients will also be flagged on the Medication Review Tool and the LTC Master templates. If a medication review if performed on the repeat template screen, the Medication Review Tool template will be opened if gastroprotection may be needed (if enabled at the unit). 

Steroid Checklist

The Steroid Checklist allows the clinician to check that appropriate information has been given to the patient and to record relevant information. 

Long Term or Frequent Corticosteroid use 
Long Term or Frequent Corticosteroid use 
Indication for steroid 
Date Started 
Initiating Clinicianneam 
Current Supervising Team 
Steroid Treatment Card Issued? 
O Yes 
O No 
O Not Known 
Advised to see optician? 
O Yes 
O No
Advised to avoid chickenpox]measles? 
O Yes 
O No 
O Not known 
Steroid Emergency Card Issued? 
O Yes 
O No 
O Not known 
Steroid Sick Day Rules Discussed PIL? 
O Yes 
O No 
O Not Known 
Finish

The most recent information recorded in the checklist is shown on the Steroid template.  The checklist can be completed by clicking on the checklist button on the Steroid template, or, if there is already an entry, right clicking on the last entry and choosing Copy Questionnaire to update the information. 

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