La corticothérapie systémique au long cours : représentations des patients, perceptions des prescripteurs et observance thérapeutique

Nassar, K.; Janani, S.; Roux, Christian; Rachidi, Wafae; Etaouil, N.; Mkinsi, O.

doi:10.1016/j.rhum.2013.04.008

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…à Casblanca en 2014 a retrouvé un taux de 62,3% en ce qui concerne la prescription de la corticothérapie générale. L'indication majeure dans leur série était la polyarthrite rhumatoïde (50,4%) suivie du lupus et des vascularites [ 8 ]. De même, Lamchahab et coll.…”

Section: Discussionunclassified

“…Le déséquilibre tensionnel, le diabète, les complications neuropsychiatriques et l'ostéoporose sont des effets rencontrés dans leur série mais à un moindre degré [ 10 ]. Quant aux seconds auteurs, seules les complications métaboliques (prise de poids) et cutanées sont très fréquemment signalées (respectivement dans 59,4% et 23,2% des cas), l'ostéoporose était une complication rare dans leur série [ 8 ]. Cette rareté de l'ostéoporose dans leur série tout comme l'absence de cette complication dans notre série peut s'expliquer par l'absence de dépistage active de cette pathologie au Bénin liée à l'indisponibilité d'une ostéodensitométrie dans notre pays.…”

Section: Discussionunclassified

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Prévalence des complications de la corticothérapie chez les sujets ouest-africains consultant en rhumatologie

Zomalheto¹,

Hilaire²,

Zossoungbo³

et al. 2015

Pan Afr Med J

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IntroductionLes corticoïdes sont pourvoyeurs d'effets secondaires multiples responsables de leur mauvaise réputation. L'objectif de ce travail a été d’établir la prévalence des complications de la thérapie cortisonique chez les sujets ouest-africains souffrant d'affection rhumatologique au CNHU-HKM de Cotonou.MéthodesIl s'agissait d'une étude rétrospective sur 5 ans portant sur des dossiers de patients de diverses nationalités reçus dans l'unité de rhumatologie du CNHU-HKM de Cotonou. Nous avons répertorié les complications liées à la prise des corticoïdes donnés dans le cadre des pathologies rhumatologiques. Les données ont été analysées grâce au logiciel EXCELL version 2013.Résultats745 (17,1%) avaient reçu l'indication d'une corticothérapie. Ils étaient de nationalités diverses de l'Afrique de l'ouest dont 87,4% de béninois. L’âge moyen des patients était de 51,15±21,58 (10-73) ans. La sex ratio était 0,61. Il s'agissait d'une corticothérapie par voie générale dans 65,1%. Les complications étaient présentes chez 31,1% des patients toute voie confondue. Celles engendrées par les infiltrations étaient dominées par la décoloration cutanée en regard du site d'injection (40%) alors que la corticothérapie générale était responsable de la prise de poids dans plus d'un cas sur 2.ConclusionLes complications de la thérapie cortisonique sont diverses et variées. La manipulation des dérivés cortisoniques doit se faire avec prudence en tenant compte du terrain et surtout de l’évaluation à chaque moment du rapport bénéfice-risque.

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Section: Discussionunclassified

Prévalence des complications de la corticothérapie chez les sujets ouest-africains consultant en rhumatologie

Zomalheto¹,

Hilaire²,

Zossoungbo³

et al. 2015

Pan Afr Med J

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“…Several quantitative studies have assessed the AEs of long-term corticosteroid therapy and the variety of different regimens adopted by physicians to reduce the risk of their development [10–12]. Other studies have evaluated patient adherence to the treatment [13–15], their knowledge and perception of AEs [16–19], as well as patient commitment to following dietary advice and recommendations for physical activity [20, 21].…”

Section: Introductionmentioning

confidence: 99%

Long-term corticosteroid use and dietary advice: a qualitative analysis of the difficulties encountered by patient

Nogué

Rambaud

Fabre

et al. 2019

BMC Health Serv Res

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Background Nearly 1% of the population is currently treated with long-term corticosteroid therapy. When corticosteroids are introduced, information concerning potential adverse effects and recommendations for lifestyle changes aimed at preventing such effects is provided to patients. However, studies have shown patients often do not fully comprehend the information provided and have difficulty implementing the recommended dietary and physical activity advice. In this study, we aim to highlight the difficulties encountered by patients in comprehending and implementing recommendations in the context of long-term corticosteroid use. Such information can be used to better optimize care, particularly concerning adherence to the treatment, the diet, and thus improve the quality of life of patients. Methods We recruited adult patients under long-term corticosteroid (≥ 3 months, ≥ 5 mg/day) treatment from both general medicine and rheumatology practices. We performed a qualitative analysis based on semi-structured interviews of these patients. Transcripts of these interviews were then compiled and analysed using a thematic approach. Results Sixteen patients were included. Analysis of the interviews revealed that patients’ hope for effective corticosteroid treatment was counterbalanced by concerns over potential adverse effects. In some patients, the need to respect a strict and imposed diet induced psychological distress, potentially leading to eating disorders or fear of social exclusion. Furthermore, patient ambivalence toward the therapeutic education was highlighted, as well as the notion of filtering information, conscious or unconscious, as revealed by their lack of recall. The relationship with the physician also affected the treatment experience. Conclusion Our analysis of the personal experience of patients regarding recommended lifestyle changes associated with long-term corticosteroid treatment highlights patient difficulties and suggests different ways of improving therapeutic education. Electronic supplementary material The online version of this article (10.1186/s12913-019-4052-y) contains supplementary material, which is available to authorized users.

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Adverse Effects of Long-Term Oral Corticosteroids in the Department of Dermatology, Antananarivo, Madagascar

Sendrasoa¹,

Ranaivo²,

Raherivelo³

et al. 2021

CCID

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Background Long-term oral corticosteroids have an important role in dermatological care in Madagascar. However, significant adverse effects have been associated with continuous exposure to oral corticosteroids. Objective We aim to assess the adverse effects of long-term corticosteroid therapy in patients seen in the Department of Dermatology at the University Hospital Joseph Raseta Befelatanana Antananarivo (UH/JRB), Madagascar, and to identify the risk factors associated with these adverse effects. Methods A cross-sectional study was conducted during 4 months to assess the adverse effects of long-term corticosteroid therapy in patients seen in the Department of Dermatology. Patients treated with oral corticosteroids for more than 3 months were included in our study. Results The prevalence of long-term use of oral corticosteroids in the Department of Dermatology of UH/JRB was 34.28%. A total of 51 patients were included and adverse effects occurred in 64.70% of this population. Repetitive infections and cutaneous adverse reactions were the most frequent adverse effects, in 23.52% and 11.76% of cases, respectively. There were no correlations between age, gender, type of disease treated, the molecule used or daily dose and the risk of adverse effects. Patients who received a corticosteroid dose of more than 40 mg daily (longer than 3 months) or a high cumulative dose of corticosteroids had a high risk of adverse effects. Conclusion Repetitive infections and cutaneous adverse reactions are the most frequent adverse effects of long-term oral corticosteroid use. Prescribing the lowest effective dose may reduce the risk of these adverse effects. Furthermore, prevention of the adverse effects of corticosteroids through diet, calcium and vitamin D supplementation is strongly recommended during long-term oral corticosteroid therapy.

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La corticothérapie systémique au long cours : représentations des patients, perceptions des prescripteurs et observance thérapeutique

Cited by 5 publications

References 25 publications

Prévalence des complications de la corticothérapie chez les sujets ouest-africains consultant en rhumatologie

Prévalence des complications de la corticothérapie chez les sujets ouest-africains consultant en rhumatologie

Long-term corticosteroid use and dietary advice: a qualitative analysis of the difficulties encountered by patient

Adverse Effects of Long-Term Oral Corticosteroids in the Department of Dermatology, Antananarivo, Madagascar

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