Systematic review of trends in prophylaxis of corticosteroid-induced osteoporosis: the need for standard audit guidelines
| Autor: | G. A. W. Bruyn, van Eric Roon, M. Duyvendak, Mark Naunton, Jacobus R. B. J. Brouwers |
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| Přispěvatelé: | Science in Healthy Ageing & healthcaRE (SHARE) |
| Rok vydání: | 2007 |
| Předmět: |
Male
corticosteroid medicine.medical_specialty ORAL CORTICOSTEROIDS Endocrinology Diabetes and Metabolism Osteoporosis MEDLINE Audit PATIENT-CARE CYCLICAL ETIDRONATE medicine Steroid-induced osteoporosis Humans Raloxifene GLUCOCORTICOID-INDUCED OSTEOPOROSIS Medical prescription MYASTHENIA-GRAVIS Intensive care medicine bisphosphonates Glucocorticoids study quality INDUCED BONE LOSS Medical Audit Bone Density Conservation Agents business.industry STEROID-INDUCED OSTEOPOROSIS TREATED PATIENTS medicine.disease RHEUMATOID-ARTHRITIS Clinical trial Treatment Outcome CLINICAL-PRACTICE Practice Guidelines as Topic Physical therapy Female prophylaxis Guideline Adherence business medicine.drug Medical literature |
| Zdroj: | Osteoporosis International, 19(10), 1379-1394. SPRINGER LONDON LTD |
| ISSN: | 1433-2965 0937-941X |
| Popis: | Corticosteroid-induced osteoporosis (CIOP) is currently undertreated. Systematic review of the literature revealed that the percentage of patients treated adequately is dependent on study quality. Therefore, it remains unknown whether adherence to the guidelines is really so poor. Five major quality criteria provide the standard for future studies on this scope.Introduction It has recently been stated that the degree of prophylaxis of corticosteroid-induced osteoporosis (CIOP) is low and effort should be put into determining reasons for non-prescribing of preventive agents. The aim of this study was to identify: how many studies adequately audit the prevalent guideline; the longitudinal trends in prevention of CIOP; which patient groups appear to be most undertreated; and which intervention strategies are effective.Methods We performed a comprehensive search of MEDLINE and systematically recorded the outcomes and quality of published studies, using five major criteria.Results Twenty-four studies were included in the analysis. The quality of the included studies was poor (31%) or moderate (37%). There was a longitudinal increase in quality of the studies and percentage of prevention. Multivariable linear regression showed that the quality of the study was the only independent predictor of the prevention rate reported in the study.Conclusions The results show undertreatment of CIOP might be due to insufficient quality of the studies rather than poor practice or failure to recognise the right patients. Future interventions should comply with five major quality criteria, and a multifaceted approach is required in order to make an impact on the underprescribing of CIOP prophylaxis. |
| Databáze: | OpenAIRE |
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