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首页> 外文期刊>International journal of clinical rheumatology. >Prevention of glucocorticoid-induced osteoporosis: a re-audit of dual-energy x-ray absorptiometry scan access and management guideline compliance
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Prevention of glucocorticoid-induced osteoporosis: a re-audit of dual-energy x-ray absorptiometry scan access and management guideline compliance

机译：预防糖皮质激素诱发的骨质疏松症：对双能X线骨密度仪扫描访问和管理指南合规性的重新审核

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Aim: To evaluate the current use of bone densitometry and agents to prevent glucocorticoid-induced osteoporosis. In 2004 we undertook a similar audit which showed poor adherence, and problems highlighted during that audit were lack of awareness and no access to public dual-energy x-ray absorptiometry (DEXA) facilities. Staff awareness was increased by local presentations and arrangements were made to have access to DEXA scans. This 2009 re-audit was carried out in order to establish what improvements in care had occurred in the intervening 4 years. Methods: A chart review was conducted for all patients seen in rheumatology outpatient departments, for a period of 8 weeks. Patients, prescribed any individual dose of glucocorticoids for more than 3 months, were identified and their medical records were audited. Results: Only 3.58% of patients were identified taking glucocorticoids for more than 3 months, versus 6% in 2004. In the over 65 years age group, none had a DEXA scan and 95% were on appropriate prophylaxis, versus 67% in 2004. In the under 65 years group, none had a pathological fracture history; only 38% of patients had a DEXA scan and were on appropriate treatment, versus none in 2004. Only 29.4% of patients were prescribed steroids for inflammatory joint disease, versus 61.7% in 2004. Overall, 74% of patients were appropriately managed as per recommended guidelines versus only 26% in 2004. Conclusion: A major improvement was noted in the management of glucocorticoid-induced osteoporosis; however, service deficiencies tend to persist.
机译：目的：评估目前使用的骨密度测定法和药物预防糖皮质激素引起的骨质疏松症。在2004年，我们进行了一次类似的审核，结果显示依从性差，审核期间突出的问题是意识不足，无法使用公共双能X线骨密度仪（DEXA）。通过本地演示增加了员工的意识，并安排了使用DEXA扫描的权限。这项2009年的重新审核是为了确定在过去4年中在护理方面取得了哪些进步。方法：对所有在风湿病科门诊就诊的患者进行图表审查，为期8周。确定了患者，处方了任何单独剂量的糖皮质激素超过3个月，并对其医疗记录进行了审核。结果：只有3.58％的患者接受了糖皮质激素治疗超过3个月，而2004年为6％。在65岁以上的年龄组中，没有进行DEXA扫描的患者和95％接受了适当预防的患者，而2004年为67％。在65岁以下的人群中，没有人有病理性骨折史。只有38％的患者接受了DEXA扫描并接受了适当的治疗，而2004年则没有。只有29.4％的患者因发炎性关节疾病而接受了类固醇治疗，而2004年为61.7％。总体上，74％的患者接受了适当的治疗建议的指南，而2004年仅为26％。结论：糖皮质激素引起的骨质疏松症的治疗有显着改善。但是，服务缺陷往往会持续存在。

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