Osteoporosis prophylaxis during corticosteroid treatment: failure to prescribe.
OBJECTIVE
To investigate prescribing patterns to prevent steroid induced osteoporosis. To compare prophylactic prescribing with National Osteoporosis Society (NOS) guidelines.


METHODS
All patients (n=92) taking oral corticosteroids admitted to general medical wards at a district general hospital were prospectively investigated over a nine month period.


RESULTS
Variations from recommended management were revealed. Altogether 64.7% of all inpatients who qualified for prophylaxis for steroid induced osteoporosis were not provided with any suitable agent. It was also found that 21.6% of those who qualified for treatment received a bisphosphonate, the only treatment currently licensed for preventing steroid induced osteoporosis. Of those prescribed prophylactic treatment, a bisphosphonate was selected for 39.3%, hormone replacement therapy was given to 25.0%, and 35.7% received treatment that is not recommended in NOS guidelines.


CONCLUSIONS
This study revealed substantial variations from NOS guidelines. It is suggested that osteoporosis prophylaxis during steroid treatment is promoted by local hospital guidelines, hospital and community pharmacists, audit, and general practitioners.
Hart
S R
SR
St Thomas' Hospital, London Royal Sussex County Hospital, Brighton, Sussex.
Green
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D020249:Hormone Replacement Therapy / Q000379:methods; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced* / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011239:Prednisolone / Q000009:adverse effects*; D011446:Prospective Studies
D004164:Diphosphonates; D005938:Glucocorticoids; D011239:Prednisolone