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ISRN Gastroenterology
Volume 2013, Article ID 862312, 5 pages
http://dx.doi.org/10.1155/2013/862312
Clinical Study

Utilization of Preventive Measures for Glucocorticoid-Induced Osteoporosis among Veterans with Inflammatory Bowel Disease

1Arthritis and Clinical Immunology Research Program Oklahoma Medical Research Foundation, 825 NE 13th Street, MS 22, Oklahoma City, OK 73104, USA
2Inflammatory Bowel Disease Center, 825 NE 10th Street, Oklahoma City, OK 73014, USA
3Department of Medicine, University of Oklahoma Health Sciences Center, P.O. Box 26901, WB1140, Oklahoma City, OK 73126, USA
4Oklahoma City Veterans’ Affairs Medical Center, 921 NE 13th Street, Oklahoma City, OK 73104, USA

Received 13 February 2013; Accepted 3 March 2013

Academic Editors: A. Keshavarzian, L. Rodrigo, C. Sperti, and W. Vogel

Copyright © 2013 Aikaterini Thanou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. We examined current osteoporosis prevention practices in patients with inflammatory bowel disease (IBD) on chronic steroid using the 2003 American Gastroenterological Association guidelines as standard of care. Methods. We identified all IBD patients followed at the Oklahoma City VA Medical Center from January 2003 to December 2010, who had been on daily oral steroids (prednisone ≥5 mg or budesonide ≥6 mg) for ≥3 consecutive months. Associations of calcium and vitamin D (vitD) prescribing and bone mineral density (BMD) testing with patient characteristics were examined by logistic regression. Results. Sixty-three of 384 consecutive patients met inclusion criteria. Among 86 steroid courses, calcium and vitD were concurrently prescribed in 46%, and BMD was tested in 30%. There was no association of demographic and clinical characteristics with calcium/vitD prescribing and BMD testing. By multivariate analysis, steroid initiation after 2006, compared to before 2006, was associated with a significant increase in calcium (OR = 3.17 and ) and vitD (OR = 2.96 and ) prescribing and BMD testing (OR = 4.63 and ). Conclusions. We observed a low, yet increasing, adherence to osteoporosis prevention guidelines in IBD since 2003, which highlights the need for continued physician education to enhance guideline awareness and implementation.