Authors: Walker-Bone, Karen; Wood, Angela; Hull, Richard; Ledingham, Joanna M.; McCrae, Fiona C.; Shaban, Ragai; Thomas, Alastair; Mackay, Kirsten

Source: Clinical Medicine, Journal of the Royal College of Physicians, Vol. 4 No. 5 September/October 2004 , pp. 431-436(6)

Publisher: Royal College of Physicians

Abstract:

Glucocorticoids are associated with increased risk of bone loss and fracture. This study compared the prescribing of bone protective agents by rheumatologists in clinical practice with the standards recommended in the 1998 UK Consensus guidelines. All glucocorticoid users who attended rheumatology outpatients during a four-week period were eligible. Notes were audited according to a predefined proforma. Among the 1,290 rheumatology outpatients seen in the study period, 189 (15%) were taking glucocorticoids. 63% of glucocorticoid patients were taking calcium and 46% vitamin D. In total, 124 (71%) of the 175 patients available for review were at high risk of osteoporotic fracture, of whom 76 (61%) were taking appropriate prophylaxis. In 26 (15%) patients, insufficient information was available to be able to quantify the risk of fracture. The study showed that the audit standard was not met in 39% of cases. A better strategy for the monitoring of clinical risk factors is therefore required.

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Keywords: GLUCOCORTICOID-INDUCED OSTEOPOROSIS; GUIDELINES; PROPHYLAXIS

Document Type: Research article

Publication date: 2004-09-01

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• Clinical Medicine is published six times a year and circulated to 20,000 Fellows and Members of the Royal College of Physicians. The journal is read by physicians both established and in training in hospitals across the world. It features a wide range of articles including original papers, professional issues, clinical guidance, medical humanities, ethics and clinical governance. The journal publishes the key features from the College lectures and conferences. Each issue has a CME section which reviews the latest advances in a chosen specialty.
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