The Use of Glucocorticoids by Rheumatologic Patients Before Attending a Specialized Department in México

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Abstract

Objective:

To explore the extent and characteristics of glucocorticoid use by patients before attending a Mexican Rheumatology Department.

Material and Methods:

This is a cross-sectional study of 1000 consecutive first-time adults admitted to the outpatient clinic in a period of 6 months. Data were collected through a self-administered questionnaire, physician interviews, and prescription notes.

Results:

Four hundred and sixty-one (58%) of 800 questionnaires analyzed reported glucocorticoid use: 73% of them were continuous users; 63% received long and 36% medium biologic half life compounds; and each patient received a median of 2 glucocorticoids (range, 1–42). The median daily, maximum, and cumulated doses—equivalent to prednisone—were 5 mg (0.7–70 mg), 6 mg (1.1–1250 mg), and 513 mg (5–151,209 mg); 46% of the patients received oral and 22% intramuscular compounds. General physicians and nonrheumatologist specialists produced 55% and 20% of the initial prescriptions. Although, the percentage of glucocorticoid users was higher among patients with inflammatory conditions (odds ratio 4.2, 95% confidence intervals 3.06–5.85), up to 44% of patients with noninflammatory diseases also received glucocorticoids. Ninety-one (20%) patients had gross adverse events.

Conclusions:

Before their first visit to a specialized department, nearly two-thirds of rheumatologic patients had taken glucocorticoids, which in most cases resulted from inappropriate prescription or recommendations by general physicians, nonrheumatologist specialists, and lay people.

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