Long-Term Oral Corticosteroid-Therapy: Description of the Practice of Adjuvant Measures by Dakar Medical Specialists

• 作者: A. C. Ndao A. Faye A. Pouye B. C. Fall B. Djiba B. S. Kane J. T. Ahouandogbo M. A. Ndour M. Ba M. Dieng M. Niasse M. Sow N. Diagne S. Ndongo
• 来源期刊: 风湿病与自身免疫疾病期刊(英文)
• 学科: 医学
• 关键词: CORTICOSTEROID LONG-TERM ORAL CORTICOSTEROID Systemic Disease ADJUVANT Measures
• 年，卷（期）: 2020,（2）
• 页码范围: 70-78
• 页数: 9页
• 分类号: R73

摘要

Introduction: The extended administration of corticoids by oral way for a length of more than 3 months defines the long-term-corticosteroid-therapy. This one, used in numerous indications, displays most often at the risk of undesirable effects linked sometimes to the habits of prescription of the doctors. Patients and Methods: In order to study the prescription modalities of this treatment, we conducted a cross-sectional, multicentric and descriptive study from June 1st, 2017 to August 1st, 2017, over a period of 2 months. It involved a questionnaire given to medical specialists of all medical specialties and practicing in the University Hospital of Dakar. Results: 170 doctors were interviewed. Dermatologists and internists were mostly found 19.4% and 18.8% or 33% and 34% doctors. Systemic autoimmune diseases alone accounted for 48% of prescription reasons. Prednisone was prescribed in 88% of cases. The immunosuppressive dose of 1 mg/kg was most often prescribed. Practitioners very heterogeneously prescribe most adjuvant measures to prolonged systemic corticosteroid therapy. Thus, the recommendation of a low-sodium diet (38% of physicians), and the systematic prescriptions of proton pump inhibitors (44.7% of physicians) and vitamin-calcium supplementation were frequently performed by physicians (34% of physicians). While the low carbohydrate diet was advocated by less than a quarter of doctors and the prevention of pneumocystosis and osteoporosis were rare (respectively 61% and 52% of prescribers did not). Conclusion: The global analysis of the habits of our medical specialists concerning the use of long-term glucocorticoids reflected a diversity of indications, heterogeneity of practices, with certain habits not in accordance with the usual recommendations.