Guideline Promotion Increases Prescription of Bone Protection with Steroids in Hospitalised Patients

Ir Med J. 2015 Jul-Aug;108(7):216-7.

Abstract

Guidelines for the prevention of glucocorticoid (GC) induced osteoporosis (GIOP) were implemented in a level 5 Irish Hospital with cross sectional audit of inpatient prescribing undertaken before and after. Prior to guideline implementation, elemental calcium (Ca) with Vitamin D (VitD) was prescribed for 11/66 (17%) of patients on GCs with 2/66 (3%) also receiving bisphosphonate (BP) therapy. Subsequent to guideline implementation, Ca with VitD was prescribed for 19/55 (35%) of patients on GCs with 11/55 (20%) also receiving BP therapy, representing a 2 and 6 fold respective increase. Internal promotion of guidelines is an effective strategy for healthcare improvement but needs refinement with or without repetition to achieve better patient outcomes.

MeSH terms

  • Bone Density / drug effects
  • Bone Density Conservation Agents / therapeutic use*
  • Calcium, Dietary / therapeutic use
  • Clinical Audit
  • Cross-Sectional Studies
  • Diphosphonates / therapeutic use
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects*
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Ireland
  • Osteoporosis* / chemically induced
  • Osteoporosis* / prevention & control
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Secondary Prevention / methods
  • Vitamin D / therapeutic use

Substances

  • Bone Density Conservation Agents
  • Calcium, Dietary
  • Diphosphonates
  • Glucocorticoids
  • Vitamin D