A national study highlights that more than one in six adults in England received at least one corticosteroid prescription in 2023, underscoring widespread use and the need for safer alternatives
A major new national study confirms that corticosteroids are among the most widely prescribed medicines in primary care in England. Researchers analysed health data from millions of patients, finding steroids were most commonly given for respiratory, skin, and joint conditions, which raises questions about long-term use and alternatives.
The findings are published in the Lancet Primary Care.
Study methods and prescription patterns
In a study led by researchers from Imperial College London and colleagues from various UK universities, the team analysed data from over 2.5 million patients using the Clinical Practice Research Datalink (CPRD) Aurum, a national database representing around 20% of English GP practices.
The researchers found that over 12 million corticosteroid prescriptions were issued during 2023, most commonly for respiratory, skin, and joint conditions. Inhaled corticosteroids, used to treat asthma and chronic obstructive pulmonary disease (COPD), accounted for the largest share (44%), followed by topical (20%), nasal (14%), and oral (14%) formulations.
“Corticosteroids are really important medications used to reduce inflammation in many different conditions. They are often among the first treatments prescribed, but we know that their overuse or misuse can lead to side effects or new health problems. We wanted to understand the current landscape of corticosteroid prescribing in England to set the scene before conducting further research to quantify the side effects of corticosteroids and understand which patients may be best suited to other types of medications that are available. Ultimately, this work will help to strengthen prescribing guidelines and improve population health,” said Dr Hannah Whittaker, lead author from Imperial’s School of Public Health.
Half of the patients prescribed corticosteroids lacked clear diagnosis
The study revealed that only half of patients prescribed corticosteroids had a clearly documented clinical indication, such as asthma or eczema, in their medical records, suggesting that potential gaps in documentation could make it harder to review treatment or side effects.
Within those with a recorded indication, asthma was the most common (63%), with eczema (18%) and COPD (17%) following. Many patients had conditions affecting multiple organ systems, most often respiratory and dermatological diseases.
Corticosteroids are associated with a range of side effects, including weight gain, osteoporosis, and immune suppression, particularly with prolonged use. Given the increasing number of biologic and other targeted treatments now available, the researchers say their findings establish an important baseline for monitoring prescribing patterns and evaluating the impact of new therapies on patient outcomes and safety.
“Our findings highlight the need for further research to inform prescribing guidelines and improve monitoring, so that unnecessary exposure to corticosteroids can be reduced and patients receive the safest and most effective treatments,” said Dr Whittaker.
