Glucocorticoid -induced osteoporosis: prevalence of preventive treatment in population of a closed health system

Abstract

The use of glucocorticoids (GC) is associated with loss of bone mass and increased risk of fractures. The objectives of this study were to establish the prevalence of chronic treatment with GC in the population of a community hospital, to evaluate the percentage of patients treated for glucocorticoid-induced osteoporosis (GIO) and type of treatment implemented in the population consuming GC with and without fractures.We evaluated patients older than 18 years with chronic treatment with GC (for over 3 months). Data were obtained from GC purchases, medication for GIO, fracture and bone densitometry detailed on electronic medical records. The population with chronic use of GC (2493 patients) represented 1.7% of institutional members (n = 146647). Mean age was 68 ± 15 years in predominantly (63.6%) female patients. Prescription included: GC oral inhalation, parenteral and oral and inhaled GC at 35.6%, 36.5%, 11.2% and 16.8%, respectively. There were no differences of age, sex and fractures in subgroups according to the different types of GC administration. 41% received bisphosphonate-predominant (26.6%) and vitamin D (22.2%) treatment for GIO. The treated population relative to untreated patients had higher percentage of fractures (20.4% vs. 8.6%, p<0.0001), densitometry studies (26.1% vs. 8.4%, p<0.0001) and consumed fewer drugs for associated diseases (p<0.001). 62.3% of patients with fractures (13.6%) received treatment for GIO. In our study, a low percentage of the population that chronically consumed in GC received preventive treatment for osteoporosis, which showed a poor and insufficient institutional intervention. More physician and patient awareness of the importance of this preventive treatment is required.