Review: corticosteroid usage: observations at a community hospital.
Corticosteroids have revolutionized the medical treatment of many diseases. However, their value is limited by substantial potential adverse effects. Therefore, the authors reviewed their clinical use at their community medical center by comparing physician decisions about therapeutic management with the indications published in the current medical literature. They retrospectively reviewed 100 consecutive charts of patients from 1993 to 1994 who received corticosteroid therapy during their hospital stay. They found that 36 patients received appropriate corticosteroid intervention, 49 received partially appropriate corticosteroid intervention, and 15 received inappropriate corticosteroid intervention when compared with current medical literature recommendations for patients with the corresponding diagnoses. Ninety-five percent of patients given "partially appropriate" corticosteroid therapy and 73% given "inappropriate" corticosteroid therapy experienced medication-related side effects compared with 19% of patients given appropriate corticosteroid therapy intervention (P < 0.05). No patient records addressed the possibility of steroid-related osteoporosis. There were no significant differences in the clinical course of the three groups of patients treated with corticosteroids. On the basis of these data, the majority of hospitalized patients given corticosteroids did not receive them entirely in accordance with literature recommendations; these patients experienced increased medication toxicity and did not receive prophylaxis for osteoporosis. These limited observations suggest opportunities to improve patient care.
Pensabeni-Jasper
T
T
Department of Medicine, Saint Barnabas Medical Center, Livingston, New Jersey 07039, USA.
Panush
R S
RS
D004363:Drug Utilization; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006764:Hospitals, Community; D006801:Humans; D009515:New Jersey; D010024:Osteoporosis / Q000139:chemically induced; D010347:Patient Care Planning / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome
D005938:Glucocorticoids