Don't know why it won't let me copy the link, I'm just getting my grandchildren ready for school, then will try and get the link, have managed to copy this.....
This letter is for you to adapt for your patient(s). [Make any changes or additions necessary in the highlighted sections and delete any unwanted information.] Please also ensure that once you have made your amendments, any important information isn’t split across two pages, or that an instruction to continue on to a second page is added.
Why your medicine is being stopped
Stopping inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD)
What are inhaled corticosteroids?
Inhaled corticosteroids (ICS) are very important medicines used to treat respiratory (breathing) conditions such as asthma and chronic obstructive pulmonary disease (COPD). These medicines reduce inflammation in the lungs.
Products that contain inhaled corticosteroids include:
Seretide® (containing fluticasone)
Symbicort® (containing budesonide)
Fostair® (containing beclometasone)
What are the side effects of inhaled corticosteroids?
Using ICS especially in high doses for a long amount of time can lead to an increased risk of side effects such as:
• Development of diabetes
• Osteoporosis and fractures
• Behavioural effects, e.g. sleep disorders, anxiety, depression, aggression.
ICS can also cause side effects to certain areas of the body such as:
• Hoarseness (strained voice)
• Sore throat
• Thinning of the skin (especially in older people)
• Oral thrush (a type of fungal infection).
If you have a type of inhaler called a metered dose inhaler, you can reduce the risk of these types of side effects by using a spacer device (picture shown) with inhalers that contain corticosteroids and rinsing your mouth out with water (and spitting out) after using any ICS.
Why are my inhaled corticosteroids being stopped?
Inhaled corticosteroids have been reported to reduce frequency and severity of flare-ups (increased breathlessness, increased phlegm, discoloured phlegm and worsening symptoms), but they have not been shown to improve your lung function, or stop it getting worse. However the side effects of these drugs can cause problems with your other illnesses.
The doctor/nurse [delete as appropriate] has reviewed your treatment and feel that your COPD could be managed without using an ICS at this time. With your agreement, your ICS will be reduced slowly (please see the end of this leaflet for details) and we would like to see you in two weeks.
In line with national guidance and guidelines agreed by [insert name] Clinical Commissioning Group (CCG) we may prescribe another long acting reliever, e.g. salmeterol or formoterol, if you are not already using one. Long acting relievers work by reducing wheeze and breathlessness. When they are used regularly they help improve levels of activity and exercise and may reduce the risk of a flare up. It is also important to continue to take any other reliever therapy that you may be on, e.g. salbutamol.
What happens if l do get a flare-up?
If you do develop a flare up and experience worsening breathlessness, increased phlegm, discoloured phlegm or your symptoms get worse, it is important to start taking antibiotics and/or prednisolone early to prevent symptoms from getting worse. Your doctor or nurse may give you (or you may already have been given) an emergency supply of antibiotics and steroid tablets to keep at home and these should be used as soon as your symptoms change, in line with your self management plan. Please check to see if you have been given either of these. You should keep the contact details of your COPD service, GP or nurse nearby at all times.