- Currently taking oral or inhaled corticosteroids - Major medical or psychiatric comorbidities precluding the use of corticosteroids (e.g. poorly controlled diabetes mellitus, chronic heart disease, chronic renal disease, chronic liver failure, schizophrenia or thought disorder, bipolar disorder) - Immunosuppression or treatment for malignancy - Hypersensitivity to corticosteroids, thiamine, wheat, lactose, povidone, maize starch or magnesium stearate - History of alcohol dependence or at risk alcohol intake - At risk for thiamine deficiency (e.g. eating disorders, chronic malabsorption) - Requires urgent transfer to the emergency department at the time of assessment - Patient declines or is unable to provide consent - Lactating or pregnant women - No access to a personal or loaned electronic device, - Unable to read or write English

- Currently taking oral or inhaled corticosteroids - Major medical or psychiatric comorbidities precluding the use of corticosteroids (e.g. poorly controlled diabetes mellitus, chronic heart disease, chronic renal disease, chronic liver failure, schizophrenia or thought disorder, bipolar disorder) - Immunosuppression or treatment for malignancy - Hypersensitivity to corticosteroids, thiamine, wheat, lactose, povidone, maize starch or magnesium stearate - History of alcohol dependence or at risk alcohol intake - At risk for thiamine deficiency (e.g. eating disorders, chronic malabsorption) - Requires urgent transfer to the emergency department at the time of assessment - Patient declines or is unable to provide consent - Lactating or pregnant women - No access to a personal or loaned electronic device, - Unable to read or write English