Glucocorticoid‐induced osteoporosis: unawareness or negligence in India?

Abstract

BACKGROUND: The burden of osteoporosis is on the rise and glucocorticoids are one of the leading causes of drug-induced osteoporosis. According to available guidelines, patients on long-term glucocorticoid therapy should receive adequate prophylaxis to prevent osteoporosis. OBJECTIVES: To compare prescription patterns in relation to Royal College of Physicians (RCP) Guidelines 2002. To identify prescribing trends for prophylaxis and management of steroid-induced osteoporosis. METHODS: We conducted a retrospective audit for patients in a tertiary care center to determine whether clinicians are evaluating and appropriately following prophylactic guidelines for corticoid-induced osteoporosis. Information regarding risk assessment for osteoporosis, instructions regarding its prevention, bone mineral density measurements, and prophylactic therapy were recorded. RESULTS: One hundred and five patients (38 men and 67 women), more then 18 years of age were included in this study. Of the 105 patients, 56% had at least one documented intervention for osteoporosis prevention (calcium, vitamin D, bisphosphonates or a bone mineral density study). Only three patients received bisphosphonates for osteoporosis prophylaxis. CONCLUSION: The study shows poor pre-therapeutic risk assessment, absence of instructions regarding preventive measures, inappropriate investigation for presence of osteoporosis, and unacceptable absence of bone protective agents.