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Published online November 3, 2022.
Can educational training decrease excessive and inappropriate steroid use in patients with inflammatory bowel disease?
Physician education can minimize inappropriate steroid use in patients with inflammatory bowel disease: the ACTION study

Yehyun Park, Chang Hwan Choi, Hyun Soo Kim, Hee Seok Moon, Do Hyun Kim, Jin Ju Kim, Dennis Teng, Dong Il Park. Intest Res. 2022;20(4):452-463

Although a variety of biologics for inflammatory bowel disease (IBD) have emerged and are increasingly used, steroids are still a cornerstone for inducing remission in patients with active ulcerative colitis (UC) or Crohn’s disease (CD). However, they are like a double-edged sword, and excessive steroid use is associated with diverse short- and long-term adverse events. Therefore, their maintenance use is not recommended.

The present study documented the frequency of excessive or inappropriate steroid use and investigated whether education on appropriate steroid use changes the steroid use pattern of physicians. The educational training was conducted in a way that a medical expert educated physicians face-to-face on appropriate steroid use and sent them a monthly email reminder of practice guidelines for 6 months.

  1. In this observational cohort study, 9.2% (155 of 1,685) of patients received steroids within a year.
  2. Among them, 29.7% (46 of 155) used steroids excessively and 34.8% (16 of 46) of whom inappropriately used excessive steroids.
  3. The educational intervention could decrease the frequency of excessive steroid use by 9.7% (29.7% → 20.0%).
  4. Severe disease was associated with excessive steroid use in cases with UC, but not with CD.
Read more about excessive steroid use or dependency in South Korean patients with IBD and the effect of physician education on minimizing inappropriate steroid use.

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