My first encounter with steroid tapers was likely in medical school, but I most vividly remember writing a number of long (3-6 week) steroid tapers for patients with chronic obstructive pulmonary disease (COPD) in residency. My favorite patient (long now deceased) was a retired military police officer with end stage COPD with frequent hospitalizations for exacerbations. Back then, tobacco cessation, home O2, steroids and theophylline (!) were about all we had. I worked closely with his wife to ensure understanding of the tapers I would write in conjunction with his pulmonologist over those 3 years of residency, but I always worried she didn’t fully understand it–he certainly didn’t. Thankfully, times and the medical evidence have changed and rarely do we taper steroids for COPD and/or asthma anymore (unless over 3 weeks) and avoid long regimens over 7-14 days except for those with the most severe disease. However, plenty of other medications require tapering regimens and they remain notoriously difficult to follow.
Here at iMedicalApps we have reviewed a number of medical apps from the Medical College of Wisconsin including Friendly Base Deficit Calculator and more recently, Symptom Tracking Application for Concussion (S.T.A.C.). Their latest medical app is called Steroid Taper Calculator and like its predecessors, was developed via a contest between physician-student teams. Undergrads from the University of Wisconsin-Milwaukee worked with physicians and scientists at the Medical College of Wisconsin to design their apps. Their new Steroid Taper app attempts simply the process of prescribing a prolonged steroid taper for patients. The medical app walks providers through the process for oral (tabs or liquid) steroids and even emails the patient a handy summary including a calendar of the taper to print.
Evidence based medicine
The app allows for near total control of the steroid taper by the provider but does have a reminder concerning the “adrenal point” where the risk of adrenal insufficiency increases and slowing of the steroid tapering may be necessary. No references are provided.
What patients/providers would benefit from this Medical App?
Any provider who prescribes steroid tapers to patients particularly those in primary care and/or specialties such as rheumatology, neurology, endocrinology and pulmonology where complicated tapers may be more frequent.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
- Step by step algorithm to follow.
- Permits tapering by fixed dose or percentage of dose for tabs and liquid steroids.
- Ability to email patient a summary of the schedule and calendar to print.
- Available for Android.
- No directions on the use of the medical app or references to support the algorithm it uses.
- Interface can be challenging to navigate.
- No ability to import summary into patient’s mobile device calendars.
- Cannot print directly from medical app.
The Steroid Taper app from the University of Wisconsin is their best medical app they have produced so far. The medical app is pretty easy to use and truly could improve patient care by avoiding dosing errors. The interface would benefit from clear instructions on use and purpose of the app.
- Overall Score
- User Interface
Interface is easy to follow but the app needs directions on how to use it/explanation of some terms.
- Multimedia Usage
The mediacl app permits the user to email the taper summary as a PDF to patients for printing.
App is free.
- Real World Applicability
This is a medical pp that definitely could get some use in primary care and other specialties who prescribe steroids. Steroid tapers are notoriously hard to follow for patients and providers frequently do not do a proper job writing out or explaining them to patients. My only issue is the frequency with which most primary care providers would use the app since steroid tapering for the conditions we most commonly treat do not require tapering in most cases.
- Device Used For Review
iPhone 6S running iOS 9.3.1
- Available for DownloadAndroidiPhoneiPad