Glucocorticoid-induced osteoporosis: unawareness or negligence in India?
BACKGROUND
The burden of osteoporosis is on the rise and glucocorticoids are one of the leading causes of drug-induced osteoporosis. According to available guidelines, patients on long-term glucocorticoid therapy should receive adequate prophylaxis to prevent osteoporosis.


OBJECTIVE
To compare prescription patterns in relation to Royal College of Physicians (RCP) Guidelines 2002. To identify prescribing trends for prophylaxis and management of steroid-induced osteoporosis.


METHODS
We conducted a retrospective audit for patients in a tertiary care center to determine whether clinicians are evaluating and appropriately following prophylactic guidelines for corticoid-induced osteoporosis. Information regarding risk assessment for osteoporosis, instructions regarding its prevention, bone mineral density measurements, and prophylactic therapy were recorded.


RESULTS
One hundred and five patients (38 men and 67 women), more then 18 years of age were included in this study. Of the 105 patients, 56% had at least one documented intervention for osteoporosis prevention (calcium, vitamin D, bisphosphonates or a bone mineral density study). Only three patients received bisphosphonates for osteoporosis prophylaxis.


CONCLUSIONS
The study shows poor pre-therapeutic risk assessment, absence of instructions regarding preventive measures, inappropriate investigation for presence of osteoporosis, and unacceptable absence of bone protective agents.
Gera
Chanchal
C
Department of Medicine, Christian Medical College & Hospital, Ludhiana, Punjab. cgera@rediffmail.com
Vij
Amarjit Singh
AS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008318:Malpractice / Q000706:statistics & numerical data*; D008485:Medical Audit; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000453:epidemiology; D012307:Risk Factors; D055815:Young Adult
D050071:Bone Density Conservation Agents; D005938:Glucocorticoids