THE ROLE OF FEAR OF CORTICOSTEROIDS IN NONPARTICIPATION IN EARLY INTERVENTION WITH INHALED CORTICOSTEROIDS IN ASTHMA AND COPD IN GENERAL-PRACTICE

Treatment of chronic airflow obstruction with inhaled corticosteroids at an early stage has been shown to preserve the lung function. We tes ted the hypothesis that ''fear of corticosteroids'' may be an importan t reason for nonparticipation in the Detection, early Intervention and Monitoring programme on Chronic obstruction pulmonary disease (COPD) and Asthma (''DIMCA'') project. One thousand seven hundred and forty n ine adult subjects from 10 general practices were invited to participa te in the several parts of the ''DIMCA'' programme. Refusers were ques tioned about the reason(s) for nonparticipation. Together the screenin g, monitoring and three drug interventions of the study showed on aver age 25-35% refusers. The most frequent reasons for nonparticipation we re absence of pulmonary symptoms and lack of time. For those invited t o take part in one of the three drug interventions, ''dislike of medic ation'' was the most important reason for nonparticipation (33, 45 and 67% of the refusers), ''Fear of corticosteroids'' specifically was th e reason for nonparticipation in 8% of the refusers on the basis of '' dislike of medication''. We concluded that a specific fear of corticos teroids was not a major obstacle for early intervention with inhaled c orticosteroids.