title: Patient perceptions of glucocorticoid side effects: a cross-sectional survey of users in an online health community.
abstract: To identify the side effects most important to glucocorticoid (GC) users through a survey of a UK online health community (Healthunlocked.com).
  
  
  
  Online cross-sectional survey.
  
  
  
  Participants were recruited through Healthunlocked.com, an online social network for health.
  
  
  
  Adults who were currently taking GCs, or had taken GCs in the past month.
  
  
  
  Responders scored the importance of listed side effects from 1 to 10, with 10 being of high importance to them. For each side effect, histograms were plotted, and the median rating and IQR were determined. Side effects were ranked by median ranking (largest to smallest) and then IQR (smallest to largest). The scores were categorised as low (scores 1-3), medium (scores 4-7) and high (scores 8-10) importance.
  
  
  
  604 responders completed the survey. Histograms of side effect scores showed a skew towards high importance for weight gain, a U-shaped distribution for cardiovascular disease (CVD), diabetes, eye disease and infections, and a skew towards low importance for acne. When ranked, the side effect of most importance to responders was weight gain (median score=9, IQR 6-10) followed by insomnia and moon face with equal median score (8) and IQR (5-10). Three serious side effects, CVD, diabetes and infections, were ranked of lower importance overall but had wide ranging scores (median score=8, IQR 1-10).
  
  
  
  The three most highly rated side effects were not clinically serious but remained important to patients, perhaps reflecting their impact on quality of life and high prevalence. This should be taken into consideration when discussing treatment options and planning future GC safety studies.
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, School of Biological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
authors.forename: Ruth
authors.identifier: 0000-0003-2709-6666
authors.initials: R
authors.lastname: Costello
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, School of Biological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
authors.forename: Rikesh
authors.initials: R
authors.lastname: Patel
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, School of Biological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Humphreys
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, School of Biological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.|NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: John
authors.initials: J
authors.lastname: McBeth
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, School of Biological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.|NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.|Health eResearch Centre, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
authors.forename: William G
authors.initials: WG
authors.lastname: Dixon
mesh_terms: D000152:Acne Vulgaris / Q000139:chemically induced; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D002386:Cataract / Q000139:chemically induced; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000139:chemically induced*; D005128:Eye Diseases / Q000139:chemically induced*; D005260:Female; D005901:Glaucoma / Q000139:chemically induced; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007239:Infections / Q000139:chemically induced*; D020407:Internet; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced; D010465:Perception; D012111:Residence Characteristics; D012871:Skin Diseases / Q000139:chemically induced; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced; D060756:Social Networking; D057896:Striae Distensae / Q000139:chemically induced; D011795:Surveys and Questionnaires; D006113:United Kingdom; D015430:Weight Gain
chemical_list: D005938:Glucocorticoids
keywords: Patient beliefs; Side effects; Steroids