On the 13^th of August 2020, NHS England published a patient safety alert for patients at risk of adrenal suppression, please see further information here.

The Ardens NPSA steroid alert searches have been designed to help practices identify patients who have recently had multiple issues of steroid medications or a diagnosis or suspected diagnosis of hypoadrenalism.

To access the searches, navigate to the Population Reporting module > Ardens Searches > 2.15 Prescribing - CAS alerts > Clinical >Steroid alerts (NPSA) folder.

This folder contains a suite of searches displaying patients who have been issued more than 3 steroid prescriptions within the last 3 months, but have not been issued a steroid card within the last 3 years:  

These searches are broken down by any steroid medication, or non-topical steroid medication, as well as separating those patients where these medications are on repeat. Whilst the NPSA alert did not specifically exclude topical steroids, Ardens’ clinical team felt that to include them would lead to excessive ‘false positives’ as most patients on topical steroids are unlikely to be having doses sufficient to cause adrenal suppression.

The AQ Suspected or confirmed hypadrenalism search identifies patients who have a confirmed or suspected code for hypoadrenalism on their records and have not been issued a steroid card within the last 3 years.

The Steroid card issued last 3 years search displays all patients who have been issued a steroid card in the last 3 years.

A printable steroid card is available in the Ardens document templates folder called: “Corticosteroid monitoring (v14.2)(Ardens)”.

This document can be printed directly from a patients record using Create letter and searching corticosteroid in the Find Document Templates screen:

We also have an NPSA steroid card pop up alert to notify you if an at-risk patient has not had a card issued within the last 3 years and enables you to issue the card. This is triggered when issuing steroid medication (oral, rectal, inhaled but NOT topical).

You will then be presented with a multiple choice question:

Selecting the Print NHS steroid emergency card option will launch the Ardens Corticosteroid Monitoring document :

Select Print > Save and Close to save to the patients records.

If you require any further assistance please contact Ardens EMIS support:  support-emis@ardens.org.uk