TITLE:
Long-Term Oral Corticosteroid-Therapy: Description of the Practice of Adjuvant Measures by Dakar Medical Specialists
AUTHORS:
M. Dieng, B. Djiba, M. Sow, B. S. Kane, J. T. Ahouandogbo, M. Ba, M. A. Ndour, B. C. Fall, M. Niasse, N. Diagne, A. C. Ndao, A. Faye, S. Ndongo, A. Pouye
KEYWORDS:
Corticosteroid, Long-Term Oral Corticosteroid, Systemic Disease, Adjuvant Measures
JOURNAL NAME:
Open Journal of Rheumatology and Autoimmune Diseases,
Vol.10 No.2,
May
14,
2020
ABSTRACT: 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.