Sir,

Patients attending a specialist uveitis clinic are commonly prescribed systemic corticosteroids.1 The United Kingdom Medicines and Healthcare Regulatory Agency guidelines state that all patients prescribed systemic corticosteroids for >3 weeks should receive a ‘Steroid Treatment Card’,2, 3 which gives guidance on minimising risk and provides details of prescriber, drug, dosage, and treatment duration. We have audited current compliance levels. All patients prescribed ⩾5 mg daily oral prednisolone attending a specialist adult uveitis clinic (Royal Liverpool University Hospital) during a 1-month period (April 2009) were questioned on steroid card use. All patients were told about the benefits of the card. Compliance with card use was reaudited among those reattending clinic within 2 months.

During the initial 1-month audit period, 243 patients attended the clinic. Of these, 73 (34 male, 39 female) met the above criteria. At the initial visit, 30 subjects (41%) were compliant with steroid card use (ie were carrying a steroid card). For patients prescribed between 5 and 19 mg/day, 43% were compliant (n=54); for 20–39 mg/day, 33% were compliant (n=9); and for ⩾40 mg/day, 40% were compliant (n=10). Of the steroid cards seen, 21 (70%) recorded an up-to-date dosage. Of the original cohort, 44 subjects (60.3%) re-attended the clinic during the subsequent 2-month study period. Of these, 27 (61%) were carrying a steroid card: an improvement in compliance. Of the steroid cards seen, 22 (81%) recorded an up-to-date dosage.

Our work shows that current steroid card compliance is suboptimal, but can be improved. Ophthalmologists prescribing long-term steroids should emphasise the importance of the card.