The efficacy of immediate diet for reducing local adverse events of inhaled corticosteroid: a pilot study

Abstract

Background: Local adverse events associated with inhaled corticosteroid use, including dysphonia, pharyngitis and oral candidiasis, can affect adherence for treatment. 'Mouth rinsing method' has been used for reducing local adverse events, but it cannot ensure complete prevention. The goal of this pilot study was to identify whether the 'immediate diet method' can reduce local adverse events in a limited number of patients.

Methods: The study was conducted in a total of 98 patients, who had been prescribed a medium-dose fluticasone propionate for the first time, from January to October in 2010. One training nurse had performed the education on how to use the inhaler, including the mouth rinsing method. And with follow-ups at one month intervals, any patient who experienced such adverse events were educated on the immediate diet method, having a meal within 5 minutes after using an inhaler and they were checked on any incurrence of adverse events with one month intervals for 2 months.

Results: The mean age of patients was 65.9 years old. The local adverse events had incurred from 18.4% of the study subjects. When performed the follow-up observation in 18 patients with local adverse events after education on the immediate diet method, 14 patients (77.8%) had shown symptomatic improvements. Three of 4 patients did not show any improvement, in spite of implementing the immediate diet method. The other 1 patient did not practice the immediate diet method properly.

Conclusion: The immediate diet method may be useful in reducing the local adverse events, caused by the use of inhaled corticosteroid.

Keywords: Candidiasis, Oral; Drug Toxicity; Dysphonia; Pharyngitis; Steroids.

Figure 1

The prevalence of local adverse events of inhaled corticosteroids. When checked on any incurrence of adverse events at 98 patients, who had been prescribed a medium-dose fluticasone propionate with one month interval for 2 months, a total 18 patients experienced local adverse events (7 men, 11 women). Of those 18 patients, 7 patients developed oral candidiasis (3 men, 4 women), 6 patients incurred sore throat (2 men, 4 women), and 5 patients developed hoarseness (2 men, 3 women).

Figure 2

Changes of the prevalence of local adverse events of inhaled corticosteroid after education of the immediate diet. When performed the follow-up observation in 18 patients with local adverse events after education on the immediate diet, 13 patients had shown symptomatic improvements 1 month later, and total of 14 patients had shown symptomatic improvements 2 months later. Five of 7 patients with oral candidiasis had improved 2 months later; all of 6 patients with sore throat had improved after 2 months, and 3 of 5 patients with hoarseness had improved 2 months later with a follow-up observation.