title: Self-medication with steroids in inflammatory bowel disease.
abstract: BACKGROUND
  The self-prescribing rates of corticosteroids in inflammatory bowel disease (IBD) patients treated with biologicals are unknown.
  
  
  OBJECTIVE
  To investigate the frequency and modalities of self-medication with steroids in adult IBD patients.
  
  
  METHODS
  Patients with IBD who attended Nancy University Hospital between November 2012 and May 2013 were included in the study. Patients were interviewed using an 11 item questionnaire.
  
  
  RESULTS
  100 patients participated in the survey. In total 15 patients (15%) had already used corticosteroids without medical prescription since their IBD diagnosis and 4 patients of them (27%) used steroids as self-medication while on anti-TNF treatment. The mean total duration of corticosteroid treatment was 24 days (range 1.5-105). In total 4 patients (27%) used corticosteroids more than 10 times without medical prescription (range 1-20). The two main reasons were the need for quick relief of symptoms (n=6) and the unwillingness to consult a physician (n=3).
  
  
  CONCLUSIONS
  A relatively high proportion of patients with IBD use corticosteroids without medical prescription. Due to their side effects, self-medication may include 'steroid dependency' as it may reflect uncontrolled disease. As steroids have significant side effects and patients may have active disease it is important to counsel patients and to monitor their self-prescribing patterns in IBD patients.
authors.affiliation: Inserm U954 and Department of Hepato-Gastroenterology, Nancy University Hospital, Université de Lorraine, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Filipe
authors.affiliation: Department of Gastroenterology, Ulster Hospital, Belfast, Northern Ireland, UK.
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Allen
authors.affiliation: Inserm U954 and Department of Hepato-Gastroenterology, Nancy University Hospital, Université de Lorraine, France. Electronic address: peyrinbiroulet@gmail.com.
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D000069285:Infliximab / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012651:Self Medication / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab
keywords: Inflammatory bowel disease; Self-medication; Steroids