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Perceptions of pharmacists about adverse effects of corticosteroid therapy: focus on osteoporosis
J Q Hudson1, R E Small, L Buckley
1Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee, Memphis, USA.
Objective:
To assess the perceptions of pharmacists regarding the adverse effects of corticosteroids, in particular corticosteroid-induced osteoporosis.
Design:
Mailed survey of a random sample of pharmacists.
Setting:
Richmond, Virginia.
Participants:
350 community and hospital pharmacists.
Interventions:
Not applicable.
Main Outcome Measures:
Respondents' knowledge of adverse effects of corticosteroid therapy in men, premenopausal women, and postmenopausal women; the content of respondents' usual patient counseling for low- and high-dose therapy; and respondents' opinions of regimens for prevention of osteoporosis.
Results:
Pharmacists associated gastritis, weight gain, and mood changes with corticosteroid use in a hypothetical 45-year-old man or 45-year-old premenopausal woman. For a hypothetical 65-year-old postmenopausal woman, pharmacists more frequently counseled about weight gain, osteoporosis, and gastritis. Patient counseling focused on these adverse effects for both low-dose (5 to 10 mg/day) and high-dose (> or = 30 mg/day) prednisone use. Osteoporosis was considered more likely in patients receiving high-dose corticosteroids on a long-term basis.
Conclusion:
Pharmacists responding to this survey frequently overlooked the association between low- and high-dose corticosteroid use and decreased bone density. Educational efforts are needed so that pharmacists can fulfill their potential for educating patients, monitoring corticosteroid therapy, and detecting drug-induced complications.
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