Use of oral corticosteroids in the community and the prevention of secondary osteoporosis: A cross sectional study
Use of oral corticosteroids in the community and the prevention of secondary osteoporosis: A cross sectional study
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DOI：
10.1136/bmj.313.7053.344
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发表时间：
1996-08-10
影响因子：
--
通讯作者：
Tattersfield, AE
中科院分区：
文献类型：
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作者：
Walsh, LJ;Wong, CA;Tattersfield, AE
目的 - 确定普通人群中持续使用口服类固醇的患病率、处方情况以及服用口服类固醇的患者接受治疗以预防骨质疏松症的程度。设计 - 一项对药物治疗进行四年回顾性审查的横断面研究。 背景 - 诺丁汉郡中部和南部的八个大型全科诊所。 受试者 - 65 786 名患者（52% 女性）在全科医师注册期间进行了登记。 1995. 结果-303 名 12-94 岁患者（65%（197 名女性））目前正在“持续”（至少三个月）口服皮质类固醇治疗。这一数字占总人口的 0.5%，占 55 岁或以上患者的 1.4% (245/17 114)（女性占 1.7% (166/9601)）。常用的类固醇是泼尼松龙（97%（294/303）），平均剂量为8.0毫克/天，149名患者确定的口服类固醇治疗的中位持续时间为三年。连续口服类固醇的最常见病症是类风湿性关节炎（23%（70））、风湿性多肌痛（22%（66））和哮喘或慢性阻塞性气道疾病（19%（59））。在过去四年中，303 名服用口服类固醇的患者中，只有 41 名 (14%) 接受过预防骨质疏松症的治疗。尽管 41 名患者中有 37 名是女性，但在 45 年以上连续服用口服皮质类固醇的女性中，只有 10% (18/181) 目前正在接受激素替代治疗。结论 - 如果我们的数据具有典型性，那么它们表明，英国有超过 250 000 人正在连续服用口服类固醇，其中大多数人没有采取骨质疏松症预防措施。
Objective-To determine the prevalence of continuous use of oral steroids in the general population, the conditions for which they are prescribed, and the extent to which patients taking oral steroids are taking treatment to prevent osteoporosis.Design-A cross sectional study with a four year retrospective review of drug treatment.Setting-Eight large general practices in central and southern Nottinghamshire.Subjects-A population of 65 786 patients (52% women) registered with a general practitioner during 1995.Results-303 patients (65% (197) women) aged 12-94 years were currently taking ''continuous'' (for at least three months) oral corticosteroid treatment. This figure represents 0.5% of the total population and 1.4% (245/17 114) of patients aged 55 years or more (1.7% (166/9601) of women). The usual steroid was prednisolone (97% (294/303)), the mean dose was 8.0 mg/day, and the median duration of oral steroid treatment determined in 149 patients was three years. The most common conditions for which continuous oral steroids were prescribed were rheumatoid arthritis (23% (70)), polymyalgia rheumatica (22% (66)), and asthma or chronic obstructive airways disease (19% (59)). Only 41 (14%) of the 303 patients taking oral steroids had received treatment for the prevention of osteoporosis over the past four years. Although 37 of the 41 patients were women, only 10% (18/181) of the women over 45 years taking continuous oral corticosteroids were currently taking hormone replacement therapy.Conclusions-If our figures are typical then they suggest that over 250 000 people in the United Kingdom are taking continuous oral steroids and that most of these are taking no prophylaxis against osteoporosis.