1.Analysis of the standardization and influential factors in the prevention and treatment of glucocorticoid-induced osteoporosis with drugs
Wenshuo JIANG ; Chen LIU ; Yan ZENG
China Pharmacy 2025;36(8):991-995
OBJECTIVE To analyze the standardization and influential factors medication use for the prevention and treatment of glucocorticoid-induced osteoporosis (GIOP). METHODS The data of inpatients diagnosed as rheumatic immune diseases in our hospital from January 1, 2022, to December 31, 2023, who required long-term use of glucocorticoids, were collected to analyze the risk stratification for GIOP-related fractures and the utilization of prevention and treatment drug in patients. Univariate analysis and Logistic stepwise regression analysis were employed to screen the factors influencing the standardization of prevention and treatment drug use in patients. RESULTS Among 354 patients, 148 patients (41.81%) had a low risk of osteoporotic fractures, 103 patients (29.10%) had a moderate risk, and 103 patients (29.10%) had a high risk. The top three drugs used in the prevention and treatment of GIOP were calcium supplements (78.81%), vitamin D preparations (74.01%), and anti-osteoporosis drugs (21.19%). A total of 133 patients (37.57%) used the drugs for GIOP prevention and treatment in a standardized manner. The standardization rate of prevention and treatment in patients with low fracture risk was significantly higher than those with high and moderate fracture risk, and the standardization rate in patients with high fracture risk was significantly higher than those with moderate fracture risk (P<0.05). Besides, the univariate analysis showed that low fracture risk served as a prevention factor for the standardized use of prevention and treatment drugs for GIOP, while moderate fracture risk, smoking or drinking, the occurrence of adverse drug reactions, and having an educational level below junior college were risk factors for the normative use of GIOP prevention and treatment drug (P<0.05). Logistic stepwise regression analysis showed that patients with low and moderate fracture risk, a history of smoking or drinking, and adverse drug reactions to anti-osteoporosis drugs had a lower standardization rate of prevention and treatment; patients who visited tertiary hospital for the past month and had a longer duration of glucocorticoid use had a higher standardization rate of prevention and treatment (P<0.05). CONCLUSIONS The standardized rate of prevention and treatment drugs used for GIOP in our hospital is relatively low. Patients with moderate to high fracture risk, a history of smoking or drinking, and those who experience adverse drug reactions after taking anti-osteoporosis drugs have lower rates of standardized prevention and treatment. Conversely, patients who sought treatment at tertiary hospital for the past month and had a longer duration of glucocorticoid had higher rates of standardized prevention and treatment.