Background Glucocorticoids are widely used in various rheumatic diseases. Although considered a redeeming therapy in certain situations, they have numerous side effects that must completely be understood by patients. It is imperative that latest available recommendations reach patients in order to prevent redoubtable complications.
Objectives Study aims at analyzing patient knowledge regarding glucocorticoid side effects and if the latest recommendations for preventing such effects are successfully implemented.
Methods Eligible patients (rheumatic pathology, glucocorticoid therapy >3 months, over 18 years) were included during inpatient visits between August and December 2014. Patients received self-compiled questionnaires which included patient general data (age, sex, demography, education), diagnosis and therapy information, questions regarding the awareness of potential side effects of glucocorticoids and achievement of prevention strategies.
Results Study included 85 patients, 72/85 women, median age 57.5 years. 38/85 had rheumatoid arthritis, 20/85 systemic lupus erythematous and 26/85 other diseases (systemic sclerosis, vasculitides, poly/dermatomyositis, etc), median disease duration 72 months. Median corticoid dosage at inclusion was 5 mg, while at the moment of therapy initiation median dosage was 20 mg prednisone equivalent. 41/85 (48.23%) patients considered they understood therapy purpose whilst only 28/85 (32.94%) considered to have been explained associated risks. Only 53/85 (62.35%) patients knew should not abruptly interrupt treatment and 27/85 (31.76%) were aware of hypothalamic-pituitary-adrenal axis suppression. 51/85 (60%) are aware of glucocorticoid induced osteoporosis and 40/85 (47.05%) have undergone a DXA. 39/85 (45.88%) were aware of muscular side effects and 43/85 (50.58%) knew ocular complications, 34/85 (40%) were aware of psychiatric effects. Only 31/85 (36.47%) patients were aware smoking cessation is recommended, 62/85 (72.94%) knew excessive alcohol intake must be avoided and only 20/85 (23.52%) were aware of the need for weight-bearing activities. Only 59/85 (69.41%) patients have read glucocorticoid treatment leaflet.
Conclusions Study reveals patient knowledge on glucocorticoids is not satisfactory. Although excellent side effects prevention strategies have been promoted, more efforts are needed to improve patient-doctor communication and information accessibility.
Duru N, van der Goes MC, Jacobs JW, et al,EULAR evidence-based and consensus-based recommendations on the management of medium to high-dose glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis 2013; 72:1905–13.
M C van der Goes, J W G Jacobs, M Boers, et al,Monitoring adverse events of low-dose glucocorticoid therapy: EULAR recommendations for clinical trials and daily practice, Ann Rheum Dis 2010; 69:1913–1919. doi:10.1136/ard.2009.124958
Grossman JM, Gordon R, Ranganath VK, Deal C, Caplan L, Chen W, et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis, Arthritis Care Res (Hoboken) 2010; 62: 1515–26
Acknowledgements This work received financial support through the project entitled “CERO – Career profile: Romanian Researcher”, grant number POSDRU/159/1.5/S/135760, cofinanced by the European Social Fund for Sectoral Operational Programme Human Resources Development 2007-2013”.
Disclosure of Interest None declared
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