Pattern of Steroid Use in a Tertiary Care Hospital

Abstract

Introduction: Steroid is commonly prescribed anti-inflammatory drug used in some acute conditions as well as for prolong period in different indications. This life saving drug has significant side effects. Patients with steroid hazards are frequently encountered in our clinical practice which should be minimized. Methodology: It was an Observational, Descriptive, Cross-sectional study. Study period was October 2013 to March 2014 in the department of Medicine & Endocrinology, Sir Salimullah Medical College & Mitford Hospital. Total 100 patients were taken who had history of steroid intake for more than 7.5 mg/day equivalent of prednisolone for more than 3 months by purposive sampling technique. Results: The age of patients range from 13 to 82 years. The mean age ±SD was 45.2±9.75 years. Among them 57% was female & 43% was male. Among 100 patients 67% was illiterate & 82% was from low socioeconomic condition. Out of them 80% was taking oral prednisolone for mean duration ±SD was 8 ±4 months and mean dose ±SD was 10±2 mg/day. Frequency of patients with different indications were 29% Rheumatological, 20% respiratory disease, 12% Dermatological, 12% Nephrological, 12% Hematological, 5% Neurological, 4% for mechanical pain, 3% gastrointestinal & 3% had self-intake for gaining weight. Among them 52% patients were receiving according to qualified physician's advice, 41 % overuse steroid beyond prescription & rest of them were taking without indication (abuse). The most commonly observed side effects were Cushingoid appearance (100%), skin changes (94%), weight gain (67%), Diabetes Mellitus (DM) - 64%, increased incidence of infection (56% cases) in which disseminated tuberculosis was 10%, Hypertension (HTN) - 39%, osteoporotic collapse 11%, myopathy 10%, iatrogenic adrenal insufficiency 3% and psychosis 2% patients. Conclusion: Due to lack of awareness among patients and health care provider, significant number of people overuse and sometimes abuse steroid in our country. Therefore, awareness about judicious use in our country is needed.