title: The prevention and treatment of glucocorticoid-induced osteoporosis in clinical practice.
abstract: Glucocorticoids are associated with increased risk of bone loss and fracture. This study compared the prescribing of bone protective agents by rheumatologists in clinical practice with the standards recommended in the 1998 UK Consensus guidelines. All glucocorticoid users who attended rheumatology outpatients during a four-week period were eligible. Notes were audited according to a predefined proforma. Among the 1290 rheumatology outpatients seen in the study period, 189 (15%) were taking glucocorticoids. 63% of glucocorticoid patients were taking calcium and 46% vitamin D. In total, 124 (71%) of the 175 patients available for review were at high risk of osteoporotic fracture, of whom 76 (61%) were taking appropriate prophylaxis. In 26 (15%) patients, insufficient information was available to be able to quantify the risk of fracture. The study showed that the audit standard was not met in 39% of cases. A better strategy for the monitoring of clinical risk factors is therefore required.
authors.affiliation: Brighton & Sussex Medical School, University of Brighton.
authors.forename: Karen
authors.initials: K
authors.lastname: Walker-Bone
authors.forename: Angela
authors.initials: A
authors.lastname: Wood
authors.forename: Richard
authors.initials: R
authors.lastname: Hull
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Ledingham
authors.forename: Fiona C
authors.initials: FC
authors.lastname: McCrae
authors.forename: Ragai
authors.initials: R
authors.lastname: Shaban
authors.forename: Alastair
authors.initials: A
authors.lastname: Thomas
authors.forename: Kirsten
authors.initials: K
authors.lastname: Mackay
mesh_terms: D000368:Aged; D015519:Bone Density; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D019983:Guideline Adherence; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000517:prevention & control / Q000628:therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'
chemical_list: D005938:Glucocorticoids