• J G Ryan, R K Morgan, P J Lavin, F E Murray, and P G O'Connell.
• Department of Rheumatology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland.
• Ir J Med Sci. 2004 Jan 1; 173 (1): 202220-2.

BackgroundGuidelines for the prevention of corticosteroid-induced osteoporosis (CIO) have been widely published. There are no guidelines on the use of gastro-protectants with corticosteroids (CS).AimsTo determine whether patients receiving CS therapy are evaluated and treated for osteoporosis risk, how management varied by steroid dose and diagnosis, and how many patients received gastro-protection.MethodsA retrospective audit of 4,350 patients presenting to four medical specialities.ResultsOne hundred and fifty-one patients prescribed CS were identified. Indications for CS therapy included renal transplantation (32%) and asthma/respiratory diseases (23%), inflammatory arthritis/vasculitis (32%) and inflammatory bowel disease/auto-immune hepatitis/other (13%). Risk of osteoporosis was mentioned in 13% of charts. The prescription rates for bone protection agents varied from 69% to 4% according to the medical speciality attended. Gastro-protectants were prescribed for 44% of patients.ConclusionThere are large variations among medical specialties both in the prescription of gastro-protectant agents and in the use of measures to prevent CIO. Simpler guidelines could facilitate rational prescribing in these patients.

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