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Chronic Diseases and Conditions

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Screening and treatment for osteoporosis remains low among patients taking glucocorticoids

Long-term use of glucocorticoid treatment to control inflammation often leads to osteoporosis (loss of bone mass and density). Despite recommendations to screen for and treat osteoporosis in patients using these medications for 3 or more months, less than half (42 percent) underwent bone mass measurement and/or were prescribed bone-protective medication, according to a study supported in part by the Agency for Healthcare Research and Quality (HS10389).

Researchers at the University of Alabama Center for Education and Research on Therapeutics and colleagues examined bone mass measurement, prescription of bone-sparing medication, and use of over-the-counter (OTC) calcium and vitamin D among 6,281 patients who were prescribed glucocorticoids during 2001-2003. Compared with patients taking glucocorticoids prescribed by internists, patients of family physicians had 44 percent lower odds of undergoing bone mass measurement whereas patients of rheumatologists had 48 percent higher odds. One-third of patients were not taking OTC calcium supplements, and one-fourth of those taking prescription bone-sparing medications were not taking calcium or vitamin D to prevent bone loss. Blacks were less likely than whites to be screened or treated.

See "Longitudinal patterns in the prevention of osteoporosis in glucocorticoid-treated patients," by Jeffrey R. Curtis, M.D., M.P.H., Andrew O. Westfall, M.S., Jeroan J. Allison, M.D., M.S., and others, in the August 2005 Arthritis & Rheumatism 52(8), pp. 2485-2494.

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