Tuberc Respir Dis.  2012 Aug;73(2):93-99.

The Efficacy of Immediate Diet for Reducing Local Adverse Events of Inhaled Corticosteroid: A Pilot Study

Affiliations
  • 1Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. sanghakim@yonsei.ac.kr

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.

Keyword

Steroids; Drug Toxicity; Candidiasis, Oral; Pharyngitis; Dysphonia

MeSH Terms

Androstadienes
Candidiasis, Oral
Diet
Dietary Sucrose
Diethylpropion
Drug Toxicity
Dysphonia
Follow-Up Studies
Humans
Meals
Mouth
Nebulizers and Vaporizers
Pharyngitis
Pilot Projects
Steroids
Fluticasone
Androstadienes
Dietary Sucrose
Diethylpropion
Steroids

Figure

  • 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.


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