Second Report of Questionnaire Study on Prescription of Glucocorticoid by Dermatologists and Preventive Therapy for Glucocorticoid-induced Osteoporosis

Abstract

In 2002, we reported the results of a questionnaire study on prescription of glucocorticoid by dermatologists and preventive therapy for glucocorticoid-induced osteoporosis. In the report, several points were found: 1) more than 90% of dermatologists prescribed oral corticosteroids for treatment of dermatological disorders, 2) the mean monthly numbers of patients treated with corticosteroids were 48.3 by dermatological general practioners and 14.9 by hospital dermatologists, 3) periodic checks for glucocorticoid-induced osteoporosis were done by 5.2% of general practitioners and 29.6% of hospital dermatologists, 4) preventive therapy for glucocorticoid-induced osteoporosis was administered by 38.5% of general practitioners and 50.6% of hospital dermatologists, and 5) there were no standards in their criteria for initiation of the preventive therapy. After the 1st report, the guidelines for preventive therapy for glucocorticoid-induced osteoporosis were established. Thus, a second questionnaire study was performed to understand the change in glucocorticoid use by dermatologists and preventive therapy for glucocorticoid-induced osteoporosis. The interesting points from this study are as follows: 1) the mean monthly numbers of patients treated with corticosteroids were 16.1 by general practioners and 13.5 by hospital dermatologists, 2) periodic checks for glucocorticoid-induced osteoporosis were done by 10.7% of general practitioners and 36.7% of hospital dermatologists, 3) preventive therapy for glucocorticoid-induced osteoporosis was administered by 24.0% of general practitioners and 84.4% of hospital dermatologists, and 4) bisphosphonates were the primary agent for initiation of the preventive therapy in 46.5%, which was a marked change from the first questionnaire study (12.5%). The establishment of the guidelines for preventive therapy for glucocorticoid-induced osteoporosis has changed the therapy administration for this disease in the dermatological field. Further, the bisphosphonates are less frequently administered by general practioners than by hospital dermatologists.