title: Use and misuse of glucocorticoids in the community of Raxaul Block, North Bihar.
abstract: BACKGROUND
  Glucocorticoid misuse is widely recognised but inadequately addressed issue in India. This study reports the use and misuse of glucocorticoids in Raxaul Block, North Bihar, India.
  
  
  METHODS
  A two-stage sampling method was used to interview 240 households during April and May 2013. In each household, anyone who had been sick in the last 6 months had their medication use recorded.
  
  
  RESULTS
  In total, 113 out of 334 (33·8%) were found to have taken a glucocorticoid in the last 6 months (95% CI: 28.7-38.9%). One hundred (88.4%) of these were considered to be inappropriate. Seventy-nine percent had been using glucocorticoids for more than 1 month; 60.2% were prescribed by local, unlicensed practitioners.
  
  
  CONCLUSIONS
  Glucocorticoid misuse will contribute to the burden of hypertension, diabetes, osteoporotic fracture, tuberculosis, cataracts and deaths due to hypoadrenal crisis. One in 15 people in Raxaul Block are likely to have a suppressed hypothalamo-pituitary-adrenal axis.
authors.affiliation: Junior Medical Officer, Medicine Department, Duncan Hospital, Raxaul, Bihar, India.
authors.forename: Shelesh
authors.initials: S
authors.lastname: Masih
authors.affiliation: Consultant, Community Health Department, Duncan Hospital, Raxaul, Bihar, India.
authors.forename: Sharon
authors.initials: S
authors.lastname: Cynthia Stephen
authors.affiliation: Research Co-ordinator, Research Department, Duncan Hospital, Raxaul, Bihar, India loisjarmstrong@gmail.com.
authors.forename: Lois
authors.initials: L
authors.lastname: Joy Armstrong
authors.affiliation: Consultant Physician/Endocrinologist, Medicine Department, Duncan Hospital, Raxaul, Bihar, India.
authors.forename: Philip
authors.initials: P
authors.lastname: Finny
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D005938:Glucocorticoids
keywords: Community; glucocorticoid; misuse