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.