Old bones vulnerable to long-term use of oral corticosteroids
A review of data by University of South Australia researchers has found many older people taking oral corticosteroids long-term are not having the recommended bone density tests or fracture prevention therapy, leaving them at much greater risk of fractures.
Published this week in the Journal of Pharmacy Practice and Research (JPPR), the review recommends a more thorough approach to managing the use of oral corticosteroids.
Commonly prescribed to treat chronic conditions such as rheumatoid arthritis and other inflammatory and autoimmune conditions, when prescribed for prolonged periods, oral corticosteroids are associated with a high incidence of bone loss, muscle atrophy and weakness.
A member of UniSA's research team from the School of Pharmacy and Medical Sciences, Dr Kerrie Westaway says the review of Department of Veterans' Affairs data highlights that pharmacists, doctors and patients need to be working together to better manage chronic conditions.
"We know how effective corticosteroids are, but our review shows that older people taking these medications orally and long-term should be having their regular bone density tests – and they just aren't all doing that," Dr Westaway says.
"Working together, we need to ensure that health plans are in place, and regular calcium and vitamin D supplements, light exercise and fracture prevention therapies are considered.
"Unfortunately, data from the Department of Veterans' Affairs suggests that many older Australians, who are long-term users of oral corticosteroids, are not getting bone density tests or medicines to prevent osteoporosis.
"It is vital that we encourage people to have the regular tests but also for those who are taking oral corticosteroids for longer periods, it's important that they understand the adverse effects of their medications so that they can discuss it with their doctor or pharmacist and ensure strategies are in place to protect their bones.
"It is also an important reminder to healthcare professionals to monitor their patients while they are taking oral corticosteroids long-term at prednisolone-equivalent doses greater than 5mg per day."