Misunderstandings about inhaled steroids (search) prescribed for asthma (search) may prompt some patients to cut back on the drug’s use. That could lead to asthma flare-ups, a new study suggests.

Better communication between patients and doctors could help clear the air. Doctors should explore patient beliefs about tolerance, dosing, and safety when prescribing inhaled steroids, say the researchers.

Treatment with inhaled steroids is the preferred long-term therapy for treating patients with persistent asthma, says the American Academy of Allergy, Asthma & Immunology. Inhaled steroids reduce inflammation in the airways and reduce the number of asthma attacks. The steroids used in asthma treatment are corticosteroids (search), not the dangerous anabolic steroids (search) that are sometimes abused by athletes.

While many asthma patients take their treatments as advised and freely discuss any questions or concerns with their doctors, others may have their doubts about inhaled steroids. That’s what a study of 58 adults with asthma and inhaled steroid prescriptions showed.

Participants completed surveys of their beliefs about inhaled steroids. They also wore an electronic monitoring device for a month to gauge inhaled steroid treatment use.

Participants were about 44 years old. Women made up 66 percent of the group; 66 percent were black, and 46 percent had a “very poor” family income, say the researchers.

Despite having a prescription for inhaled steroids, 64 percent of the group reported having at least one asthma flare-up per month. That might have something to do with their beliefs about inhaled steroids and their use of the treatment.

The study was conducted by doctors including Tao Tuan Le, MD, of Johns Hopkins University. Their findings were reported at the annual meeting of the American Academy of Allergy, Asthma & Immunology, held in San Antonio.

Tolerance, Dose, Safety Questioned by Some Patients

Patients were less likely to follow doctor’s orders for inhaled steroid use if they were concerned about developing a tolerance to the steroids with daily use. They were also less likely to use the steroids as directed if they thought they could get by with less than the amount prescribed and if they thought the treatment was unsafe.

Race and family income were also important. Adherence was less common among black patients and those with low family income.

People are encouraged to ask questions of their doctors. It’s one step toward understanding and making decisions about health matters.

The study doesn’t note if the asthma patients brought up their concerns about inhaled steroids with their health care providers. Doctors may want to take the lead and start the discussion when prescribing inhaled steroids, the researchers suggest.

There are things that you can do to prevent worsening of your asthma. Taking your medications as prescribed is one way to help control the disease.

By Miranda Hitti, reviewed by Brunilda Nazario, MD

SOURCES: 2005 Annual Meeting of the American Academy of Allergy, Asthma & Immunology, San Antonio, March 18-22, 2005. News release, American Academy of Allergy, Asthma & Immunology.