Glucocorticoid-Induced Osteoporosis: Are We Practicing Prevention?

Document Type

Article

Publication Date

1-21-2023

Publication Title

SN Comprehensive Clinical Medicine

Abstract

The objective of the study is to describe healthcare provider adherence with current guidelines for the management of patients at risk for glucocorticoid induced osteoporosis. This is a descriptive study. We queried the electronic database of the Department of Veterans Affairs Hospital in New Orleans and collected data on all veterans who filled systemic glucocorticoid (GC) prescriptions during a 2-year study period (January 1, 2018 to December 31, 2019). A total of 1,962 separate GC prescriptions were filled, and 1051 unique patients identified. Of those, 206 patients were prescribed GC for ≥ 90 days and comprised our study population. There was a male predominance, with 51% self-identifying as Caucasian and 46% as African American. A majority (68%) of prescriptions were for less than 10 mg prednisolone-equivalent doses per day (PED). Primary care providers were the main prescribers of long-term GC (51%, n = 105), followed by rheumatologists (24%, n = 49). BMD testing was performed in 20% of patients (n = 42). Of those tested, 14% were found to have osteoporosis, and 21% had osteopenia. Approximately half of our study population were prescribed vitamin D supplementation with 80% prescribed the guideline-recommended dose. Twenty-six percent of patients were prescribed supplemental calcium, with 44% prescribed the guideline-recommended dose. Out of the 206, 130 (63%) of the study population were on long-term and high-dose PED (> 7.5 mg/day). Of those, less than 10% were on primary prophylaxis with an anti-osteoporotic agent. GIOP remains an under-recognized and under-treated condition despite evidence-based practice guidelines. Our findings are overall worse than previously published data.

Volume

5

Issue

1

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