A Scoping Review of Self-Medication in Exogenous Cushing's Syndrome: The Role of Social Determinants of Health in the Case Report Literature.

IF 3.7 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Meghana Koleti, Claramence Dokyi, Jean Kim, L Maria Belalcazar
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Abstract

The occurrence of exogenous Cushing's syndrome (E-CS) after self-medication with over-the-counter products containing steroids is well documented. However, the potential role of underlying social determinants of health (SDoH) on the practice of self-medication resulting in CS has not been systematically investigated. Using primary sources published in the form of case reports or case series from 1998- 2024, and adhering to PRISMA-ScR guidelines, we performed a scoping review to investigate the contribution of SDoH on the occurrence of CS due to self-medication. Information on SDoH, patient demographics, product and reason for use, and clinical complications was extracted. Only reports in English and on adults were included. Thirty-six reports met inclusion criteria. Seven of eight reports from the United States involved an over-the-counter product with undisclosed steroid content marketed for joint disease; 19 of the 28 international case reports/series involved self-medication with labeled pharmaceutical products. Although complications were consistently identified, only five of 36 reports on E-CS due to self-medication discussed and three provided information on SDoH. Social factors identified included lack of access to healthcare, low health literacy, language barriers, and traditional and cultural practices. All reports, except two, were found in journals with pre-publication peer review processes. Our findings point to the weak presence of SDoH in the case report literature on E-CS due to self-medication. It is necessary to move away from solely disease-focused approaches to those that incorporate SDoH. Peer reviewers and journal editors may help advance change by requesting that case reports/series on self-medication inform on SDoH.

外源性库欣综合征自我药物治疗的范围综述:病例报告文献中健康的社会决定因素的作用
外源性库欣综合征(E-CS)的发生后,自我用药的非处方产品含有类固醇是有理有据的。然而,潜在的健康社会决定因素(SDoH)在自我药疗导致CS的实践中的潜在作用尚未得到系统的调查。使用1998- 2024年以病例报告或病例系列形式发表的第一手资料,并遵循PRISMA-ScR指南,我们进行了范围审查,以调查SDoH对自我用药引起的CS发生的贡献。提取有关SDoH、患者人口统计、产品和使用原因以及临床并发症的信息。仅包括英语和成人的报告。36份报告符合纳入标准。来自美国的8份报告中有7份涉及一种用于关节疾病的非处方药,其类固醇成分未公开;28个国际病例报告/系列中有19个涉及使用贴有标签的药品自行用药。虽然并发症一直被发现,但在36份因自我用药引起的E-CS报告中,只有5份被讨论,3份提供了SDoH的信息。确定的社会因素包括缺乏获得医疗保健的机会、卫生知识普及程度低、语言障碍以及传统和文化习俗。除了两份报告外,所有报告都是在有出版前同行评议程序的期刊上发现的。我们的研究结果表明,由于自我用药导致的E-CS病例报告文献中存在微弱的SDoH。有必要从单纯以疾病为重点的方法转向纳入SDoH的方法。同行审稿人和期刊编辑可以通过要求关于自我药物治疗的病例报告/系列报告告知SDoH来帮助推动改变。
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来源期刊
Endocrine Practice
Endocrine Practice ENDOCRINOLOGY & METABOLISM-
CiteScore
7.60
自引率
2.40%
发文量
546
审稿时长
41 days
期刊介绍: Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.
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