• Mirela Bašić Denjagić, Mirna Alečković-Halilović, Lejla Rakovac-Tupković, Predrag Jovanović, Zlatan Mehmedović, and Enver Zerem.
• Department of Gastroenterology, Clinic for Internal Medicine, University Clinical Centre Tuzla, Bosnia and Herzegovina.
• Med Glas (Zenica). 2024 Sep 1; 21 (2): 349355349-355.

AimTo evaluate the clinical impact of corticosteroids (CS) overuse in inflammatory bowel disease (IBD) patients. Excessive use of CS could delay more efficacious treatment and may indicate poor quality of care.MethodThis is a two-phase study that used Steroid Assessment Tool (SAT) to measure corticosteroid exposure in IBD patients. In the first phase, data from 211 consecutive ambulatory patients with IBD (91 with ulcerative colitis, 115 with Crohn's disease, and five with unclassified inflammatory bowel disease) were analysed by SAT. In the second phase, one year after data entry, clinical outcome of patients with corticosteroids overuse was analysed.ResultsOf the 211 IBD patients, 132 (62%) were not on corticosteroids, 45 (22%) were corticosteroid-dependent, and 34 (16%) used corticosteroids appropriately, according to the European Crohn's and Colitis Organization guidelines. In the group of patients with ulcerative colitis, 57 (63%) were not on corticosteroids, 18 (20%) were corticosteroid-dependent, and 16 (16%) used corticosteroids appropriately; in the group of patients with Crohn's disease 70 (61%), 27 (23%) and 18 (16%), respectively. Overall, 24 (out of 45; 53%) patients with IBD could avoid the overuse of corticosteroids if they had a timely change of the treatment, surgery, or entered a clinical trial.ConclusionAn excessive corticosteroid use can be recognized on time using the SAT. We have proven that excessive corticosteroid use could be avoided in almost half of cases and thus the overuse of CS may indicate poor quality of care in those patients.Copyright© by the Medical Association of Zenica-Doboj Canton.

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