title: Primary and secondary prophylaxis to the use of inhaled glucocorticoid in primary health care.
abstract: OBJECTIVE
  To investigate the extent of inhaled glucocorticoid (IGC) treatment in general and to what extent general practitioners (GPs) manage the risk of glucocorticoid-induced osteoporosis.
  
  
  METHODS
  A questionnaire was sent to all 3,617 GPs in Denmark.
  
  
  RESULTS
  The results are divided into criteria for recommending prophylaxis with calcium and vitamin D for patients in actual IGC treatment, routine examinations for osteoporosis before starting asthma or chronic obstructive pulmonary disease (COPD) treatment with IGC, and criteria for starting anti-osteoporotic treatment (bisphosphonates + calcium + vitamin D) for patients in IGC treatment. A total of 535 questionnaires were eligible for evaluation and covered almost 25% of the Danish population. In general, the questionnaires documented that physicians do not use primary nor secondary prophylaxis in their patients treated with IGC with or without risk factors of osteoporosis.
  
  
  CONCLUSIONS
  More studies are warranted to verify the effects of IGC treatment on bone health and the importance of prophylaxis to prevent osteoporosis in IGC-treated patients before outlining specific recommendations for the management of the disease.
authors.affiliation: Department of Geriatrics, Research Centre of Ageing and Osteoporosis, Glostrup University Hospital, University of Copenhagen, DK-2650 Glostrup, Denmark.
authors.forename: Barbara Rubek
authors.initials: BR
authors.lastname: Nielsen
authors.forename: Niklas Rye
authors.initials: NR
authors.lastname: Jørgensen
authors.forename: Peter
authors.initials: P
authors.lastname: Schwarz
mesh_terms: D000280:Administration, Inhalation; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects; D001249:Asthma / Q000188:drug therapy*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000009:adverse effects; D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects; D002118:Calcium / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D005194:Family Practice; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control*; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D050071:Bone Density Conservation Agents; D001993:Bronchodilator Agents; D004164:Diphosphonates; D005938:Glucocorticoids; D014807:Vitamin D; D019819:Budesonide; D002118:Calcium