Review
The patient should be reviewed in 24 hours
and on the last day of the OCS course. No
specific method is advised by guidelines
but it seems reasonable to carry out the
24-hour review face to face or by telephone.
This is to establish that recovery is maintained
(symptom resolution has been
maintained and, where possible, the
patient reports an increase in PEF), to
ensure the patient is adhering to the OCS
course, and to remind them to attend for
review on the OCS course’s last day.
Issues not already dealt with should be
addressed at the review on the final OCS
day. This includes identifying the cause of
the exacerbation, which may have resulted
from continued poor control generally; the
cause of the poor control should be identified.
Common reasons are poor adherence
to inhaled corticosteroid (ICS) regimens
and poor inhaler technique. Other factors
include smoking (which impairs ICS efficacy),
suboptimal treatment and coexisting
allergic rhinitis, which increases the
likelihood of an exacerbation if not optimally
controlled (Corren et al, 2004).
Some exacerbations may have no
obvious cause and patients report a fairly
rapid deterioration with no obviou
ReviewThe patient should be reviewed in 24 hoursand on the last day of the OCS course. Nospecific method is advised by guidelinesbut it seems reasonable to carry out the24-hour review face to face or by telephone.This is to establish that recovery is maintained(symptom resolution has beenmaintained and, where possible, thepatient reports an increase in PEF), toensure the patient is adhering to the OCScourse, and to remind them to attend forreview on the OCS course’s last day.Issues not already dealt with should beaddressed at the review on the final OCSday. This includes identifying the cause ofthe exacerbation, which may have resultedfrom continued poor control generally; thecause of the poor control should be identified.Common reasons are poor adherenceto inhaled corticosteroid (ICS) regimensand poor inhaler technique. Other factorsinclude smoking (which impairs ICS efficacy),suboptimal treatment and coexistingallergic rhinitis, which increases thelikelihood of an exacerbation if not optimallycontrolled (Corren et al, 2004).Some exacerbations may have noobvious cause and patients report a fairlyrapid deterioration with no obviou
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