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Posted on 03.16.01
Steroid-Induced Osteoporosis: Variations in Detection and Treatment
By Amy Mudano, MPH
About 1 million Americans are taking steroids, a type of drug used to combat inflammation, for diseases such as rheumatoid arthritis, chronic obstructive pulmonary disease (COPD), and asthma, among others. These drugs are very effective in controlling these serious conditions, but people who take steroids for long periods have a higher risk of certain side effects.
One toxic effect of steroids (such as prednisone) is the development of osteoporosis, or a weakening of the bones. Osteoporosis is a serious disease that increases the risk of fractures.
An important question is how well doctors identify and treat osteoporosis in their patients who take steroids. Investigators at the University of Alabama at Birmingham CERTs have studied this question in 2300 people from around the U.S. who have health-care coverage through a managed-care organization (MCO).
Using information from health-care claim forms, the investigators looked at the use of bone mineral density (BMD) testing and prescription drugs for osteoporosis among new MCO participants who were long-time steroid users.
Only 9% of patients who were taking steroids had a BMD test during the study period of 3 years, and only 21% of the patients had a prescription filled for osteoporosis-related medicines: hormone-replacement therapy, bisphosphonates, calcitonin, or raloxifene.
Patients who received a steroid prescription from a rheumatologist were more likely to have a BMD test, but received prescription therapy no more often than were patients seen by other specialists.
The findings from this study are similar to the variations in practice seen in studies of smaller, regional populations. These low rates highlight the need to educate physicians and patients about the importance of osteoporosis prevention among this highly susceptible population.