Overreliance on oral corticosteroids (OCS) in European asthma management: EU-LAMA survey.

<bold>Background:</bold> The role of OCS in asthma management has changed over the last years in the guidelines, however little is known about the physicians’ opinions and behaviours on OCS usage in asthma. <bold>Aims and objectives:</bold> The objective was to assess physicians' perceptions of the intensification of treatment regimes in not well-controlled asthma, including inhaled corticosteroids (ICS), long acting beta-2 agonist (LABA), long acting muscarinic antagonist (LAMA), biologics, and OCS. <bold>Methods:</bold> A 19-question survey was distributed in Poland, Greece, Sweden, Slovenia, and Austria, via the CATI-system platform (http://www.cati-system.pl/) using an electronic CAWI (Computer Assisted Web Interviews) method. Pulmonologists, allergologists, general practitioners, and internal medicine specialists were invited. <bold>Results:</bold> 630 surveys were completed including Poland (57.6%), Greece (27%), Sweden (6.3%), Slovenia (5.4%) and Austria (3.7%). At the question: ‘What treatment regimens (as maintenance therapy) are you most often using in adult patients with asthma who are not achieving adequate control when treated with high-dose (HD) ICS/LABA?’ the answer: ‘To add OCS to current treatment’ – was the first choice in 35% of responders in Poland, 18% in Greece, 15% in Sweden, 18% in Slovenia, 13% in Austria. At the question: ‘Which asthma treatment regime is closest to your practice?’ The answer “Adding OCS to the current treatment”–was the first choice of 17% in Poland, 9% in Greece, 8% in Sweden, 9% in Slovenia, and 9% in Austria. <bold>Conclusions:</bold> Despite the availability of LAMA and biologics, physicians seem to prefer adding OCS to asthma treatment on steps 4/5, perceiving OCS as a regime closest to their practice.