{
  "abstract": "Background: Systemic corticosteroids (SCS) are widely used in asthma and chronic obstructive pulmonary disease (COPD) management, despite proven evidence of significant adverse effects associated with their misuse/overuse. This study aimed to assess global perceptions and practices regarding SCS prescribing and dispensing for asthma and COPD among healthcare professionals responsible for managing these conditions in community and primary care settings. Methods: A cross-sectional survey was conducted among 376 participants (314 prescribers, 62 community pharmacists) across 41 countries. The self-administered questionnaire captured SCS prescribing behaviours, perceptions of overuse, and accessibility, including over-the-counter (OTC) availability. Results: Data from 376 respondents across 41 countries were analysed. Most prescribers reported access to asthma (83.7%) and COPD (80.8%) guidelines. Guideline availability was lower among community pharmacists (60.7% for asthma and 45.9% for COPD) and in low- and middle-income countries compared with high-income countries (asthma: 74.5 vs 84.1%; COPD: 62.1 vs 83.6%). Systemic corticosteroids (SCS) were frequently used for acute exacerbations, with notable long-term use in both asthma and COPD. Perceived SCS overuse was common (56.8% among community pharmacists and 60.3% among prescribers), largely attributed to limited access to inhaled or biologic therapies and prescriber knowledge gaps. Provision of SCS action packs and repeat SCS prescribing without consultation were reported in several countries. Substantial variation in regulatory environments was observed, with nearly half the respondents (48.4%) reporting oral SCS availability as OTC and frequent self-medication in adults. Conclusion: These findings, based on self-reported perceptions, emphasise the ongoing discrepancy between guideline recommendations and reported/perceived practices which may contribute to avoidable patient safety risks, underscoring the importance and need for enhanced stewardship, improved access to inhaled steroid therapies, and the adoption of strategies that promote the appropriate use of SCS, such as the IPCRG Right Care approach.",
  "abstract_shown": true,
  "affiliations": [
    "ProAR Foundation, Salvador, Brazil",
    "IPCRG Latam & Respiratory Study and Research Group in Primary Health Care (GEPRAPS), Santo André, Brazil",
    "International Primary Care Respiratory Group (IPCRG), Larbert, Scotland UK",
    "Family Health Unit of Minho, Health Centre Group of Braga, Braga, Portugal",
    "ICVS/3B’s Associate Laboratory, Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal",
    "Family Physician Airways Group of Canada, Stouffville, Canada",
    "Department of Clinical Pharmacy & Pharmacology, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands",
    "Pulmocare Research and Education (PURE) Foundation, Pune, India",
    "Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Juliana Franceschini",
      "orcid": "0000-0002-6166-0235"
    },
    {
      "affs": [
        2
      ],
      "name": "Siân Williams"
    },
    {
      "affs": [
        2
      ],
      "name": "Neil Fitch"
    },
    {
      "affs": [
        3
      ],
      "name": "Pedro Fonte"
    },
    {
      "affs": [
        4
      ],
      "name": "Jaime Correia-de-Sousa"
    },
    {
      "affs": [
        5
      ],
      "name": "Alan Kaplan"
    },
    {
      "affs": [
        6
      ],
      "name": "Job FM van Boven"
    },
    {
      "affs": [
        7
      ],
      "name": "Sundeep Salvi"
    },
    {
      "affs": [
        8
      ],
      "name": "Ee Ming Khoo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/f68mmeywrycbr.bib",
  "cited_by": 0,
  "doi": "10.1038/s41533-026-00549-8",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13714314/",
  "id": "f68mmeywrycbr",
  "issns": [
    "2055-1010"
  ],
  "landing_url": "https://doi.org/10.1038/s41533-026-00549-8",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "openalex",
      "2737|Asthma and respiratory diseases"
    ]
  ],
  "openalex": "W7162312803",
  "pdf_url": "https://www.nature.com/articles/s41533-026-00549-8_reference.pdf",
  "pmcid": "PMC13714314",
  "pmid": "42946728",
  "published": "2026-08-20",
  "publisher": "Nature Publishing Group",
  "ris": "https://research.draconitic.com/paper/f68mmeywrycbr.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T12:21:50Z",
      "native_id": "PMC13714314",
      "source": "pmc",
      "url": "https://doi.org/10.1038/s41533-026-00549-8"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Asthma and respiratory diseases",
      "subfield": "physiology"
    }
  ],
  "title": "Global perceptions and practices on systemic corticosteroid use for asthma and COPD in primary care: results from a multinational survey on prescribers and community pharmacists",
  "title_text": "Global perceptions and practices on systemic corticosteroid use for asthma and COPD in primary care: results from a multinational survey on prescribers and community pharmacists",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:21:50Z",
  "url": "https://research.draconitic.com/paper/f68mmeywrycbr",
  "venue": "NPJ Primary Care Respiratory Medicine",
  "versions": []
}