Use of oral corticosteroids in the United Kingdom

Citation
Tp. Van Staa et al., Use of oral corticosteroids in the United Kingdom, QJM-MON J A, 93(2), 2000, pp. 105-111
Citations number
33
Language
INGLESE
art.tipo
Article
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Journal title
QJM-MONTHLY JOURNAL OF THE ASSOCIATION OF PHYSICIANS
ISSN journal
1460-2725 → ACNP
Volume
93
Issue
2
Year of publication
2000
Pages
105 - 111
Database
ISI
SICI code
1460-2725(200002)93:2<105:UOOCIT>2.0.ZU;2-5
Abstract
Administration of oral corticosteroids is associated with the development o f osteoporosis and an increased risk of fractures. However, the size of the treated sub-population who would benefit from preventive therapy remains u ncertain. The objective of this study was to investigate the usage pattern of oral corticosteroids in a large sample representative of the general pop ulation in England and Wales. Information was obtained from the General Pra ctice Research Database (GPRD) which contains medical records of general pr actitioners. Oral corticosteroid users were patients aged 18 years or older who received one or more prescriptions for oral corticosteroids. Over 1.6 million oral corticosteroid prescriptions were issued to the cohort of 244 235 oral corticosteroid users. At any point in time, oral corticosteroids w ere being used by 0.9% of the total adult GPRD population. The highest use (2.5%) was by people between 70 and 79 years of age. Respiratory disease wa s the most frequently recorded indication for oral corticosteroid treatment (40%). Patients with arthropathies were most likely to use long-term, cont inuous treatment, and patients with chronic obstructive pulmonary disease l east likely (19.3% and 6.1%, respectively, used oral corticosteroids for mo re than 2 years). The overall use of bone-active medication (oestrogens, bi sphosphonates, vitamin D, and calcitonin) during oral corticosteroid treatm ent was low (between 4.0% and 5.5%). The current population in the UK at ri sk of developing corticosteroid-induced fractures might be as large as 3500 00. Identification of these patients will be important for implementing pre ventive strategies in a cost-effective manner.