What rhinologists and allergists should know about the medico-legal implications of corticosteroid use: A review of the literature

David M. Poetker, Timothy Smith

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: Corticosteroids are a mainstay of treatment in the management of sinonasal inflammatory disease. Despite their common use, many practitioners are not well versed in their potential complications or the medico-legal ramifications of their use. The objectives of this review were to outline the existing data of the medico-legal implications of oral steroids. Methods: An OVID database search of the terms "corticosteroids OR adrenal cortex hormones "AND "medico-legal ORmalpracticeOR jurisprudenceOR expert testimonyOR informed consent "was performed. This search was then narrowed to English language articles and the titles and abstracts were searched for relevance. Results: TheOVID search identified 178 articles. This search was then narrowed, resulting in 9 articles thatwere relevant and included in the current review. Five articles involved database reviews of litigation associated with medications. Steroids were found to be a common medication associated with litigation and the cost of the litigation involving steroid use can be very high. Common themes associated with the litigation include poor communication and lack of informed consent regarding steroid use. Several additional articles addressed single cases and many addressed lawsuit prevention. Conclusion: Lawsuits associated with steroids are disproportionately costly and most of the allegations stem from a lack of informed consent over the use of steroids. Open dialogue with patients is the key to informed consent. Ideally, clinicians should discuss the rationale for steroid use, and the risks, expected benefits, and alternatives of the steroid therapy. Document this discussion and consider providing educational material for the patient to read and review.

Original languageEnglish (US)
Pages (from-to)95-103
Number of pages9
JournalInternational Forum of Allergy and Rhinology
Volume2
Issue number2
DOIs
StatePublished - Mar 2012

Fingerprint

Adrenal Cortex Hormones
Steroids
Jurisprudence
Informed Consent
Databases
Allergists
Midazolam
Complementary Therapies
Language
Communication
Costs and Cost Analysis

Keywords

  • Adrenal cortex hormones
  • Informed consent
  • Jurisprudence
  • Malpractice
  • Steroids

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

@article{9b42d78575544deaace012c3ed3ef107,
title = "What rhinologists and allergists should know about the medico-legal implications of corticosteroid use: A review of the literature",
abstract = "Background: Corticosteroids are a mainstay of treatment in the management of sinonasal inflammatory disease. Despite their common use, many practitioners are not well versed in their potential complications or the medico-legal ramifications of their use. The objectives of this review were to outline the existing data of the medico-legal implications of oral steroids. Methods: An OVID database search of the terms {"}corticosteroids OR adrenal cortex hormones {"}AND {"}medico-legal ORmalpracticeOR jurisprudenceOR expert testimonyOR informed consent {"}was performed. This search was then narrowed to English language articles and the titles and abstracts were searched for relevance. Results: TheOVID search identified 178 articles. This search was then narrowed, resulting in 9 articles thatwere relevant and included in the current review. Five articles involved database reviews of litigation associated with medications. Steroids were found to be a common medication associated with litigation and the cost of the litigation involving steroid use can be very high. Common themes associated with the litigation include poor communication and lack of informed consent regarding steroid use. Several additional articles addressed single cases and many addressed lawsuit prevention. Conclusion: Lawsuits associated with steroids are disproportionately costly and most of the allegations stem from a lack of informed consent over the use of steroids. Open dialogue with patients is the key to informed consent. Ideally, clinicians should discuss the rationale for steroid use, and the risks, expected benefits, and alternatives of the steroid therapy. Document this discussion and consider providing educational material for the patient to read and review.",
keywords = "Adrenal cortex hormones, Informed consent, Jurisprudence, Malpractice, Steroids",
author = "Poetker, {David M.} and Timothy Smith",
year = "2012",
month = "3",
doi = "10.1002/alr.21016",
language = "English (US)",
volume = "2",
pages = "95--103",
journal = "International Forum of Allergy and Rhinology",
issn = "2042-6976",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - What rhinologists and allergists should know about the medico-legal implications of corticosteroid use

T2 - A review of the literature

AU - Poetker, David M.

AU - Smith, Timothy

PY - 2012/3

Y1 - 2012/3

N2 - Background: Corticosteroids are a mainstay of treatment in the management of sinonasal inflammatory disease. Despite their common use, many practitioners are not well versed in their potential complications or the medico-legal ramifications of their use. The objectives of this review were to outline the existing data of the medico-legal implications of oral steroids. Methods: An OVID database search of the terms "corticosteroids OR adrenal cortex hormones "AND "medico-legal ORmalpracticeOR jurisprudenceOR expert testimonyOR informed consent "was performed. This search was then narrowed to English language articles and the titles and abstracts were searched for relevance. Results: TheOVID search identified 178 articles. This search was then narrowed, resulting in 9 articles thatwere relevant and included in the current review. Five articles involved database reviews of litigation associated with medications. Steroids were found to be a common medication associated with litigation and the cost of the litigation involving steroid use can be very high. Common themes associated with the litigation include poor communication and lack of informed consent regarding steroid use. Several additional articles addressed single cases and many addressed lawsuit prevention. Conclusion: Lawsuits associated with steroids are disproportionately costly and most of the allegations stem from a lack of informed consent over the use of steroids. Open dialogue with patients is the key to informed consent. Ideally, clinicians should discuss the rationale for steroid use, and the risks, expected benefits, and alternatives of the steroid therapy. Document this discussion and consider providing educational material for the patient to read and review.

AB - Background: Corticosteroids are a mainstay of treatment in the management of sinonasal inflammatory disease. Despite their common use, many practitioners are not well versed in their potential complications or the medico-legal ramifications of their use. The objectives of this review were to outline the existing data of the medico-legal implications of oral steroids. Methods: An OVID database search of the terms "corticosteroids OR adrenal cortex hormones "AND "medico-legal ORmalpracticeOR jurisprudenceOR expert testimonyOR informed consent "was performed. This search was then narrowed to English language articles and the titles and abstracts were searched for relevance. Results: TheOVID search identified 178 articles. This search was then narrowed, resulting in 9 articles thatwere relevant and included in the current review. Five articles involved database reviews of litigation associated with medications. Steroids were found to be a common medication associated with litigation and the cost of the litigation involving steroid use can be very high. Common themes associated with the litigation include poor communication and lack of informed consent regarding steroid use. Several additional articles addressed single cases and many addressed lawsuit prevention. Conclusion: Lawsuits associated with steroids are disproportionately costly and most of the allegations stem from a lack of informed consent over the use of steroids. Open dialogue with patients is the key to informed consent. Ideally, clinicians should discuss the rationale for steroid use, and the risks, expected benefits, and alternatives of the steroid therapy. Document this discussion and consider providing educational material for the patient to read and review.

KW - Adrenal cortex hormones

KW - Informed consent

KW - Jurisprudence

KW - Malpractice

KW - Steroids

UR - http://www.scopus.com/inward/record.url?scp=84862856165&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862856165&partnerID=8YFLogxK

U2 - 10.1002/alr.21016

DO - 10.1002/alr.21016

M3 - Article

C2 - 22253235

AN - SCOPUS:84862856165

VL - 2

SP - 95

EP - 103

JO - International Forum of Allergy and Rhinology

JF - International Forum of Allergy and Rhinology

SN - 2042-6976

IS - 2

ER -