Oral corticosteroid prescribing in women over 50, use of fracture prevention therapy, and bone densitometry service

• Published in: Annals of the rheumatic diseases 2003-04, Vol.62 (4), p.350-352
• Main Authors: Chantler, I W, Davie, M W J, Evans, S F, Rees, J S
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon - statistics & numerical data; Administration, Oral; Age; Age Distribution; Aged; Aged women; Aged, 80 and over; Arthritis, Rheumatoid - drug therapy; Asthma; Biological and medical sciences; Bone Density; Care and treatment; Chronic obstructive pulmonary disease; Concise Report; corticosteroids; densitometry; Diagnosis; Diphosphonates - administration & dosage; Disease; Disease prevention; Diseases of the osteoarticular system; Drug Administration Schedule; Drug therapy; England - epidemiology; Estrogen Replacement Therapy - statistics & numerical data; Female; FPT; fracture prevention therapy; Fractures; Fractures, Bone - chemically induced; Fractures, Bone - epidemiology; Fractures, Bone - prevention & control; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; Health aspects; Hip joint; Hormone replacement therapy; Hospitals; HRT; Humans; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Osteoporosis; Osteoporosis, Postmenopausal - diagnosis; PMR; polymyalgia rheumatica; Prevalence; Prevention; prophylaxis; rheumatoid arthritis; Studies; temporal arteritis; women; Womens health
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.62.4.350

Objective: To identify the most common diseases and age of corticosteroid use in women over 50, dosage in last year, duration of oral corticosteroid use, prescription for fracture prevention (drug used), and referrals for bone densitometry. Methods: General practice records from 41 practices in Shropshire identified 62 230 women aged >50 from a population of 80 082. Data on fractures, duration of corticosteroid use, dose in the study year (1 April 1997–31 March 1998), use of fracture prevention therapy and bone densitometry were sampled from one out of three records. Results: 3.2% were prescribed corticosteroids; 633 patients investigated in detail aged 70.1 (SD 10.5) years, had been prescribed 1526 (SD 1727) mg prednisolone (median 1040 mg) for 3.31 (SD 3.20) years (median 2.0 years). Patients with asthma/lung disease, most common in the younger group, had the lowest annual corticosteroid use; patients with rheumatoid arthritis (RA), polymyalgia rheumatica/temporal arteritis (PMR/TA), who were more likely to be elderly, had the highest annual use. Between the age of 70 and 79 years patients with RA had significantly more hip fractures than the other groups, and corticosteroid prescribing was most common. Bisphosphonates or hormone replacement therapy were prescribed for 48% aged 50–59 years but only 32% at 70–79 years (p