title: [Analysis of the state-of-the-art of consulting medical care to patients with glucocorticoid-induced osteoporosis or its risk according to the data of a questionnaire survey (GLUCOST study)].
abstract: OBJECTIVE
  To analyze the state-of-the-art of consulting medical care to Russian patients with glucocorticoid-induced osteoporosis (GCOP) or its risk.
  
  
  METHODS
  This GLUCOST study was organized and conducted by the Russian Association of Osteoporosis. A total of 1129 patients with chronic inflammatory diseases, who had been taking oral glucocorticosteroids (OGCSs) a long time (3 months or more), were examined. The patients filled out an anonymous questionnaire on their own. Whether the measures taken to diagnose, prevent, and treat GCOP complied with the main points of Russian clinical guidelines was assessed.
  
  
  RESULTS
  61.8% of the patients knew that the long-term treatment of GCOP might cause osteoporosis. 48.1% of the respondents confirmed the results of bone densitometry; 78.1% of the patients reported that they had been prescribed calcium and vitamin D supplements by their physician, but their regular intake was confirmed by only 43.4%; 25.4% of the patients had sustained one low-energy fracture or more. Treatment for GCOP was prescribed for 50.8% of the patients at high risk for fractures, but was actually received by 40.2%. Therapeutic and diagnostic measures were implemented in men less frequently than in women. When the patient was aware of GCOP, the probability that he/she would take calcium and vitamin D supplements rose 2.7-fold (95% Cl; 2.1 to 3.5; p = 0.001) and that he/she would follow treatment recommendations did 3.5-fold (95% Cl; 2.3 to 5.3; p = 0.001). Bone densitometry increased the prescription rate for antiosteoporotic medication and patient compliance.
  
  
  CONCLUSIONS
  According to the data of Russia's large-scale GLUCOST survey, every four patients with chronic inflammatory disease who are on long-term OGCS therapy have one low-energy fracture or more. Due to inadequate counseling, the patients are little aware of their health and do not get the care required to prevent the disease. Less than 50% of patients who have GCOP and a high risk for fractures undergo examination and necessary treatment aimed at preventing fractures.
authors.affiliation: Department of Hospital Therapy, Faculty of Pediatrics, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia.
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authors.initials: IA
authors.lastname: Baranova
authors.affiliation: Department of Therapy, Institute of Postgraduate Education, Yaroslavl State Medical Academy, Ministry of Health of Russia, Yaroslavl, Russia.
authors.forename: O B
authors.initials: OB
authors.lastname: Ershova
authors.affiliation: Laboratory of Noninvasive Diagnostic Methods, Research Institute of Pulmonary Medicine, Federal Biomedical Agency of Russia, Moscow, Russia.
authors.forename: E Kh
authors.initials: EK
authors.lastname: Anaev
authors.affiliation: City Polyclinic Two Hundred and Twenty, Moscow Healthcare Department, Moscow, Russia.
authors.forename: T N
authors.initials: TN
authors.lastname: Anokhina
authors.affiliation: Tomsk Polyclinic Six, Tomsk, Russia.
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authors.initials: ОN
authors.lastname: Anoshenkova
authors.affiliation: Laboratory of Intensive Care and Respiratory Failure, Research Institute of Pulmonary Medicine, Federal Biomedical Agency of Russia, Moscow, Russia.
authors.forename: S Z
authors.initials: SZ
authors.lastname: Batyn
authors.affiliation: Unit of Rheumatology, Tula Regional Clinical Hospital, Tula, Russia.
authors.forename: E A
authors.initials: EA
authors.lastname: Belyaeva
authors.affiliation: Internal Medicine Department One, Faculty of Therapeutics, Prof. V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia, Krasnoyarsk, Russia.
authors.forename: T Yu
authors.initials: TY
authors.lastname: Bolshakova
authors.affiliation: Rheumatology Center, Lipetsk Town Polyclinic Seven, Lipetsk, Russia.
authors.forename: I A
authors.initials: IA
authors.lastname: Volkorezov
authors.affiliation: Department of Faculty Therapy, Kuban State Medical University, Ministry of Health of Russia, Krasnodar, Russia.
authors.forename: L N
authors.initials: LN
authors.lastname: Eliseeva
authors.affiliation: Unit of Pulmonary Diseases, City Clinical Hospital Fifty-Seven, Moscow Healthcare Department, Moscow, Russia.
authors.forename: E V
authors.initials: EV
authors.lastname: Kashnazarova
authors.affiliation: Department of Hospital Therapy with Course of Phthisiopulmonology, Pacific State Medical University, Ministry of Health of Russia, Vladivostok, Russia.
authors.forename: M F
authors.initials: MF
authors.lastname: Kinyaikin
authors.affiliation: Department of Therapy and General Medical Practice, Institute of Postgraduate Education, Ivanovo State Medical Academy, Ministry of Health of Russia, Ivanovo, Russia.
authors.forename: M N
authors.initials: MN
authors.lastname: Kirpikova
authors.affiliation: Krasnoyarsk Territorial Clinical Hospital, Krasnoyarsk, Russia.
authors.forename: E P
authors.initials: EP
authors.lastname: Klyuchnikova
authors.affiliation: Research Institute of Clinical and Experimental Lymphology, Siberian Branch, Russian Academy of Sciences, Novosibirsk, Russia.
authors.forename: M A
authors.initials: MA
authors.lastname: Korolev
authors.affiliation: Allergology Unit, City Clinical Hospital Fifty-Seven, Moscow Healthcare Department, Moscow, Russia.
authors.forename: I V
authors.initials: IV
authors.lastname: Kuneevskaya
authors.affiliation: Rheumatology Unit, Saint Ioasaf Belgorod Regional Clinical Hospital, Belgorod, Russia.
authors.forename: L V
authors.initials: LV
authors.lastname: Masneva
authors.affiliation: Academician A.I. Nesterov Department of Faculty Therapy, Faculty of Therapeutics, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia.
authors.forename: A A
authors.initials: AA
authors.lastname: Muradyants
authors.affiliation: Rheumatology Center, Prof. S.I. Sergeev Territorial Clinical Hospital One, Ministry of Health of the Khabarovsk Territory, Khabarovsk, Russia.
authors.forename: E N
authors.initials: EN
authors.lastname: Otteva
authors.affiliation: Irkutsk Regional Clinical Consulting and Diagnostic Center, Irkutsk, Russia.
authors.forename: T N
authors.initials: TN
authors.lastname: Petrachkova
authors.affiliation: Rheumatology Unit, Railway Clinical Hospital at the Voronezh-1 Station, OAO 'RZhD, Voronezh, Russia.
authors.forename: L K
authors.initials: LK
authors.lastname: Peshekhonova
authors.affiliation: I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care, Saint Petersburg, Russia.
authors.forename: A S
authors.initials: AS
authors.lastname: Povzun
authors.affiliation: Department of Internal Medicine Propedeutics, Faculty of Therapeutics, Kemerovo State Medical Academy, Ministry of Health of Russia, Kemerovo, Russia.
authors.forename: T A
authors.initials: TA
authors.lastname: Raskina
authors.affiliation: Vologda Regional Clinical Hospital, Vologda, Russia.
authors.forename: M L
authors.initials: ML
authors.lastname: Smirnova
authors.affiliation: Laboratory of Osteoporosis, V.A. Nasonova Research Institute of Rheumatology, Russian Academy of Sciences, Moscow, Russia.
authors.forename: N V
authors.initials: NV
authors.lastname: Toroptsova
authors.affiliation: Hospital Therapy Department Two, Acad. E.A. Wagner Perm State Medical Academy, Ministry of Health of Russia, Perm, Russia.
authors.forename: R B
authors.initials: RB
authors.lastname: Khasanova
authors.affiliation: Department of Hospital Therapy, Kazan State Medical University, Ministry of Health of Russia, Kazan, Russia.
authors.forename: N G
authors.initials: NG
authors.lastname: Shamsutdinova
authors.affiliation: Faculty of Postgraduate Education, Acad. I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia.
authors.forename: N L
authors.initials: NL
authors.lastname: Shaporova
authors.affiliation: Department of Family Medicine, Northern State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia.
authors.forename: N S
authors.initials: NS
authors.lastname: Shitova
authors.affiliation: Outpatient Consulting Unit, Saint Petersburg Clinical Rheumatology Hospital Twenty-Five, Saint Petersburg, Russia.
authors.forename: S Yu
authors.initials: SY
authors.lastname: Shkireeva
authors.affiliation: Academician A.I. Nesterov Department of Faculty Therapy, Faculty of Therapeutics, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia.
authors.forename: N A
authors.initials: NA
authors.lastname: Shostak
authors.affiliation: Department of Family Medicine, I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia.
authors.forename: O M
authors.initials: OM
authors.lastname: Lesnyak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050723:Fractures, Bone / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D005938:Glucocorticoids / Q000009:adverse effects*; D006296:Health Services / Q000592:standards* / Q000706:statistics & numerical data; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000453:epidemiology / Q000628:therapy*; D012017:Referral and Consultation / Q000592:standards / Q000706:statistics & numerical data; D012426:Russia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D005938:Glucocorticoids