Prevalence of long term steroid treatment and the frequency of decision making to prevent steroid induced osteoporosis in daily clinical practice
Prevalence of long term steroid treatment and the frequency of decision making to prevent steroid induced osteoporosis in daily clinical practice
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DOI：
10.1136/ard.61.1.32
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发表时间：
2002-01-01
影响因子：
27.4
通讯作者：
Gudjonsson, FV
中科院分区：
文献类型：
--
作者：
Gudbjornsson, B;Juliusson, UI;Gudjonsson, FV
背景：口服皮质类固醇（CS）的使用是医源性骨质疏松症最常见的原因之一。最近，治疗指南处理的骨骼并发症的CS已经published.Objective：为了评估如何CS是在社区和频率的积极干预，对皮质类固醇引起的骨质疏松症在日常临床实践中，材料和方法：经医学伦理委员会和数据保护委员会批准后，冰岛东北部地区的药房开具的所有CS处方（人口26664）在两年的时间内收集。此后，从保健中心和当地医院的病历中获得临床信息。研究纳入了每年至少服用CS 3个月或重复服用CS（每年总共3个月）的患者。这些患者还收到了一份关于激素替代治疗，双膦酸盐，钙和维生素D的饮食消费的问卷调查结果：共有191例患者被纳入研究或人口的0.7%。他们的平均年龄为66岁（17-93岁），106/191（55%）为女性。根据他们的医疗记录，只有63名（33%）患者没有因治疗而登记的并发症。39例（20%）患者发生骨质疏松相关骨折，50例（26%）患者推测为CS诱发的骨质疏松。共有52%的患者正在接受补充维生素D（鱼肝油），37%的患者定期服用钙片，而91%的患者定期食用奶制品。只有17例（9%）患者服用双膦酸盐和18/81（22%）的绝经后妇女接受激素替代therapy.Conclusions：相对较少的患者接受长期治疗CS也接受一级预防CS引起的骨质疏松症，虽然有几个患者服用维生素D和钙片。针对骨质疏松症的特殊治疗在大多数情况下是继发于骨质疏松症并发症。因此，虽然有可用的治疗方案对CS引起的骨质疏松症，医生谁开CS没有利用这种形式的治疗他们。患者
Background: The use of oral corticosteroids (CS) is one of the most common causes of iatrogenic osteoporosis. Recently, therapeutic guidelines dealing with the skeletal complication of CS have been published.Objective: To evaluate how CS are used in the community and the frequency of active intervention against corticosteroid induced osteoporosis in daily clinical practice,Material and methods: After approval by the Committee on Medical Ethics and the Data Protection Commission all prescriptions for CS which were filled by pharmacies in the northeast area of Iceland (population 26 664) during a two year period were collected. Thereafter, clinical information was obtained from medical records at the healthcare centres and from the local hospital. Patients who were taking CS for at least three months a year or for repeated periods (for a total of three months annually) were included in the study. These patients also received a questionnaire about hormone replacement therapy, bisphosphonates, and dietary consumption of calcium and vitamin D.Results: A total of 191 patients were included in the study or 0.7% of the population. Their mean age was 66 years (17-93) and 106/191 (55%) were women. Only 63 (33%) patients had no registered complication due to the treatment, according their medical records. Thirty nine (20%) patients had had an osteoporosis related fracture and 50 (26%) of the patients had presumed CS induced osteoporosis. A total of 52% patients were receiving supplementary vitamin D (fish liver oil) and 37% were taking calcium tablets regularly, while 91 % of the patient group were consuming milk products regularly. Only 17 (9%) patients were taking bisphosphonates and 18/81 (22%) of the postmenopausal women were receiving hormone replacement therapy.Conclusions: Relatively few patients receiving long term treatment with CS are also receiving primary prevention against CS induced osteoporosis, although several patients are taking vitamin D and calcium tablets. Specific treatment against osteoporosis was in most cases instituted secondary to osteoporotic complications. Thus although there are available treatment alternatives against CS induced osteoporosis, the doctors who prescribed CS did not make use of this form of treatment for their. patients.