^aSteroid dependency or excess was defined as the presence during the preceding 12-month period of ≥1 of: the prescription of >1 steroid course, the inability to wean steroids below 10 mg QD prednisolone or 3 mg QD budesonide within 3 months of initiation, or disease flare within 3 months of stopping steroids. To determine the extent to which physicians had sought to avoid steroid dependency or excess, a standardised list of potential reasons for dependency or excess was agreed and each reason was allocated to 1 of 4 sections: 1) non‑IBD prescribing; 2) prescribing where no alternative existed or where appropriate preventative measures were taken; 3) prescribing where relevant alternatives were suboptimally explored; or 4) prescribing where relevant alternatives were not explored. For all cases, meeting the criteria for steroid dependency or excess, relevant clinic letters, biochemical parameters, and endoscopy reports were collated and anonymised before being centrally allocated for blinded peer review by a co-author from a different centre, who assigned each case to 1 of the 4 pre-agreed categories using a scoring template¹⁰; Data were collected from unselected consecutive IBD patients attending outpatient clinics over 3 months in July–September 2015. Data were obtained for a total of 1176 patients; 567 (48%) were diagnosed with CD, 575 (49%) with UC, and 34 (3%) from IBD-unclassified.¹⁰