Care recommended on the quick-fix use of steroid treatment
Mary Ann Benitez
Private doctors are unnecessarily prescribing steroids to patients as a quick fix as they compete for business, a pharmacist said yesterday, while calling for checks and balances in prescribing drugs.
Steroids have gained a bad reputation in Hong Kong after 49 Sars patients who received large doses of them developed avascular necrosis, a degenerative bone disease.
But doctors fear the public misconception could deprive patients of a life-saving drug.
On Wednesday, the Medical Council suspended Aaron Lee Fook-kay, of Yuen Long, for 10 months for prescribing steroids to a woman from 1999 to 2005 for asthma and flu, without telling her of the risk and side effects of the medication.
He continued to prescribe them even after she told him the drugs should not be prescribed to her without her consent.
William Chui Chun-ming, education director of the Society of Hospital Pharmacists, suggested a system of checks and balances among health professionals to achieve better patient care.
'Doctors cannot know everything. They need other professionals, such as pharmacists, to verify and check their prescriptions,' he said.
He said Medical Council cases of doctors' inappropriate use of steroids did not reflect the real situation. 'Why are steroids being used a lot? It is a panacea and a very powerful drug for inflammation and you can see the result quickly,' said Mr Chui, chief of the pharmacy services at Queen Mary Hospital.
'Once a doctor can improve the disease, patients think the doctor is very good. This is a business consideration. Prescribing antibiotics, steroids or high-dose cough syrups is not unusual in private practice because of high competition among family doctors,' he said.
David Hui Shu-cheong, a specialist in respiratory medicine and assistant professor at Chinese University, said he would recommend that private doctors use inhaled corticosteroids and bronchodilators as first-line treatment for asthma and other airway problems.
The treatment should be reviewed every two to three months to see if the dosage could be changed or the medication stopped.
The president of the Hong Kong Medical Association, Choi Kin, said the public and doctors should not forget that steroids were life-saving drugs for asthma, systemic lupus - a serious disease affecting the joints, kidneys, and skin - and kidney transplant patients.
'I have been prescribing it for up to 20 years in some of my patients. If not, they would have been dead,' Dr Choi said.