Case study 3. Psychological dependence
A 69-year-old man with advanced chronic obstructive pulmonary disease (COPD), anxiety and depression is seen by his GP to review the need for long term glucocorticoids. He takes prednisolone 20mg daily and feels unable to reduce the dose because of breathlessness. His weight has increased by 10kg in the past year, he has osteoporosis with a vertebral compression fracture and his random blood glucose is 12.3mmol/L.