Long-term systemic glucocorticoid therapy: Patients’ representations, prescribers’ perceptions, and treatment adherence

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

doi:10.1016/j.jbspin.2013.07.001

Cited by 18 publications

(18 citation statements)

References 23 publications

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“…Glucocorticoids are an interesting example due to multiple and sometimes complex prescribing patterns and the possibility of secondary care prescribing. In addition, GCs are associated with a range of side effects, which may lead to nonadherence to GC regimes by patients …”

Section: Introductionmentioning

confidence: 99%

Exposure measurement error when assessing current glucocorticoid use using UK primary care electronic prescription data

Joseph

Staa

Abrahamowicz

et al. 2018

Pharmacoepidemiology and Drug

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Purpose To quantify misclassification in glucocorticoid (GC) exposure defined using UK primary care prescription data. Methods A cross‐sectional study including patients with rheumatoid arthritis prescribed oral GCs in the past 2 years. Glucocorticoid exposure based on electronic prescription records was compared with participant‐reported GC use captured using a paper diary. Prescription data (containing information about prescriptions issued but no dispensing information) was provided by the Clinical Practice Research Datalink. The following variables were defined: current use and dose of oral GCs and if (and when) participants had received a GC injection. For oral GCs, self‐reported use was taken to represent “true” exposure. A dataset representing a hypothetical population was generated to assess the impact of the misclassification found for current use. Results A total of 67 of 78 study participants (86%) were correctly classified as currently on/off oral GCs; 32/38 (84.2%) participants reporting current GC use and 35/40 (87.5%) participants not reporting current use were correctly classified. Estimated values of current dose were imprecise (correlation coefficient 0.46). Concordance between reported and prescribed GC injections was poor (kappa statistic 0.14). Misclassification bias was demonstrated in the hypothetical population: For “true” relative risks of 1.5, 4, and 9, the “observed” relative risks were 1.33, 2.48, and 3.58, respectively. Conclusions Misclassification of current use of oral GCs was low but sufficient to lead to significant bias. Researchers should take care to assess the likely impact of exposure misclassification on their analyses.

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Section: Introductionmentioning

confidence: 99%

Exposure measurement error when assessing current glucocorticoid use using UK primary care electronic prescription data

Joseph

Staa

Abrahamowicz

et al. 2018

Pharmacoepidemiology and Drug

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show abstract

“…GCs have potent anti-inflammatory properties that rapidly relieve joint pain, swelling and stiffness and also prevent structural damage [ 2 ]. However, they are associated with significant and predictable side effects (SEs) of concern to both patients and physicians [ 3 , 4 ]. In the general population, GCs account for 2.5 % of all adverse drug reactions leading to hospital admission [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Half of UK patients with rheumatoid arthritis are prescribed oral glucocorticoid therapy in primary care: a retrospective drug utilisation study

Black¹,

Joseph²,

Brown³

et al. 2015

Arthritis Res Ther

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BackgroundPatients with rheumatoid arthritis (RA) have shared care between rheumatologists and general practitioners (GPs). Rheumatologists guide immunosuppressive therapy, whilst GPs rely on analgesia and glucocorticoid (GC) therapy to manage active disease. The objective of this study was to describe patterns of GC prescribing for patients with RA in primary care and to determine the influence of patient characteristics and prescriber.MethodsIncident RA patients were identified within the Clinical Practice Research Datalink, a United Kingdom (UK) primary care research database. Descriptive statistics identified patterns of oral GC prescribing. Prescribers were categorised by their tendency to prescribe GCs (high/low). Logistic regression was used to identify baseline characteristics associated with GC prescriptions during follow-up and to examine whether baseline characteristics influenced prescribing differently in high versus low prescribers.ResultsA total of 7777 patients (47 %) received ≥1 GC prescription during follow-up. The average daily dose was 7.5 mg (IQR 5–15.3 mg). Of those who received GCs, >50 % were prescribed >10 mg/day and 20 % >30 mg/day. The median proportion of time spent on GCs was 26.3 % (IQR 3.8–70.0 %). Age and cardiovascular disease (CVD) were associated with increased likelihood of receiving GCs. High prescribers more commonly prescribed GC therapy in older patients and patients with hypertension.ConclusionsHalf of patients with incident RA received GCs in primary care. Average GC use was 7.5 mg for 25 % of the time, perhaps higher usage than rheumatologists and GPs might expect. GCs were prescribed more commonly in certain high-risk populations, including older patients and those with CVD.

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“…This study done with long term glucocorticoids steroid hormone therapy. According to their result weight gain (27%) an out of (18%) patient reported episodes of treatment discontinuation [16]. It may be reason for poor knowledge about preventive measure of adverse effects of steroid therapy in Morocco.…”

Section: Discussionmentioning

confidence: 98%

Paediatric Neurology Patients: Parental Awareness of Adverse Effects of Long-term Corticosteroid Therapy

Perera¹,

Samarasekara²,

Shiwanth³

et al. 2020

Preprint

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Background: Corticosteroids are potent medications used to treat in many inflammatory conditions in paediatric neurology practice. Although corticosteroids are beneficial, their adverse effects may be numerous and vary. As parents are the primary caregivers of paediatric patients, assessing their awareness is timely important. Methods: To determine the parental awareness on adverse effects of corticosteroid therapy in Paediatric Neurology Patients in the Neurology Unit at the Lady Ridgeway Hospital, Colombo, Sri Lanka. In this descriptive cross-sectional study, 300 parents of paediatric neurology patients on long-term corticosteroid therapy in the paediatric neurology unit were included. Parents were volunteered for the study and signed informed consent. Ethical approval was obtained from the Ethics Review Committee of the same hospital. Data were collected using content validated, pre-tested self-administered questionnaire during January to March 2020. Results: Of the total parents, the majority were mothers (87%, n=262) and more than 70% (n=211) of them completed their secondary education. Findings demonstrated that parents had average awareness about adverse effects of long-term steroid therapy including child’s susceptibility to infections (69.0%, n=207), increase blood glucose levels (69.7%, n=209), moon face (60.3%. n=181), central obesity (60.3%, n=181), increase blood pressure levels (58.0%, n=174) and (irritability 50.3%, n=151) while poor awareness on adverse effects include buffalo humps (26.7%, n=80) increase fracture tendency (24.3%, n=73), tarry colour stools (24.3%, n=73), vision impairment (24.0%, n=72), glaucoma (17.3%, n=52), cataract (16.0%, n=48 ) and delayed wound healing (23.0%, n=69). According to the findings, overall mean (SD) knowledge percentage on parental awareness of adverse effects was found to be low (38.24 ± 20.57). Conclusion: Since parental awareness of the adverse effects of long-term corticosteroid therapy is inconsistent, special attention is needed to plan and implement appropriate awareness sessions.

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Long-term systemic glucocorticoid therapy: Patients’ representations, prescribers’ perceptions, and treatment adherence

Cited by 18 publications

References 23 publications

Exposure measurement error when assessing current glucocorticoid use using UK primary care electronic prescription data

Exposure measurement error when assessing current glucocorticoid use using UK primary care electronic prescription data

Half of UK patients with rheumatoid arthritis are prescribed oral glucocorticoid therapy in primary care: a retrospective drug utilisation study

Paediatric Neurology Patients: Parental Awareness of Adverse Effects of Long-term Corticosteroid Therapy

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