• community
• glucocorticosteroids
• osteoporosis
• prevalence
• prevention

We read with great interest the article by Gudbjornsson and colleagues and concur with the accompanying leader by Dr Paget on the issue of corticosteroid associated osteoporosis.^1,2 Osteoporosis is a major public health problem, associated with significant morbidity and mortality, and is estimated to cost £614 million annually in England and Wales alone. Despite well published guidelines on the prevention and treatment of corticosteroid associated osteoporosis, as a profession, we are failing to meet the targets set by these guidelines.^3,4

In the light of the American College of Rheumatology guidelines in 2001, we performed an audit of our current practice relating to the issue of steroid prescription, calcium supplementation, measurement of bone density, and the prescription of antiresorptive treatment to see if we had been adhering to the recommendations of the National Osteoporosis Society. Our rheumatology department has a continually updated database on all current and past patients who have attended our unit. This contains information on patient demographics, primary rheumatological diagnosis, comorbid conditions, current drug treatment, past disease modifying treatment (including corticosteroids), and records all patient generated events, including outpatient and inpatient episodes. From our database of over 10 000 patients, we identified 258 patients who …