Objective: To evaluate the current use of bone densitometry and agents to prevent bone loss among long-term corticosteroid users.
Methods: A telephone survey of patients receiving long-term oral corticosteroid treatment.
Results: One hundred forty-seven patients receiving a mean prednisone dose of 10 mg per day for an average of 1-2 years were surveyed. Twenty-nine percent reported having a bone density test, 29% were taking calcium supplements, and 45% were receiving vitamin D. Forty percent of postmenopausal (PMP) women were receiving hormone replacement therapy and 14%, bisphosphonate treatment. Forty-two percent of PMP women were receiving no preventive treatment. Patients who were evaluated by primary care physicians and rheumatologists were more likely to have undergone bone density testing and to have received preventive treatments than were patients of other specialists.
Conclusion: Many patients receive inadequate treatment to prevent corticosteroid-induced osteoporosis, and physician specialty is an important predictor of bone density testing and treatment. A broad educational effort directed to physicians of varied specialties is needed to ensure that osteoporosis prevention becomes the standard of care for patients receiving long-term corticosteroid treatment.