The National Patient Safety Team identified a report of a patient who was prescribed a corticosteroid for a period of two years but did not have the necessary regular reviews or monitoring for side effects to check the ongoing appropriateness of this medication. 

Corticosteroids are synthetic analogues of hormones produced by the adrenal cortex and are widely used in the management of many conditions. People receiving long-term oral corticosteroids (more than 3 weeks duration) and those needing frequent courses (three or four per year) should receive regular monitoring as they are at risk of adverse effects. 

We noted that there was limited information relating to monitoring requirements for corticosteroids in the British National Formulary (BNF) clinical resource. 

We therefore liaised with the editorial board of the BNF who added information to the drug monograph entries for designated corticosteroids (for example, Dexamethasone) outlining the patient parameters to be monitored before starting and during treatment.