Chronic glucocorticoid management in neuromuscular disease: A survey of neuromuscular neurologists

Author:

Stepanian Lora1,Laughlin Ruple S.2,Bacher Corey3,Izenberg Aaron4,Hodgkinson Victoria56,Dyck Adrienna56,Breiner Ari7ORCID,Kassardjian Charles D.8910ORCID

Affiliation:

1. School of Medicine Queen's University Kingston Ontario Canada

2. Department of Neurology Mayo Clinic Rochester Minnesota USA

3. Division of Neurology, Department of Medicine Scarborough Health Network and University of Toronto Toronto Ontario Canada

4. Division of Neurology, Department of Medicine Sunnybrook Health Sciences Centre and University of Toronto Toronto Ontario Canada

5. Department of Clinical Neurosciences University of Calgary Calgary Alberta Canada

6. Hotchkiss Brain Institute, University of Calgary Calgary Alberta Canada

7. The Ottawa Hospital Research Institute Ottawa Ontario Canada

8. Division of Neurology, Department of Medicine Unity Health Toronto and University of Toronto Toronto Ontario Canada

9. Li Ka Shing Knowledge Institute, Unity Health Toronto Toronto Ontario Canada

10. Neurology Quality and Innovation Lab Toronto Ontario Canada

Abstract

AbstractIntroduction/AimsGlucocorticoids (GC) are first‐line therapy for many neuromuscular diseases. There is a lack of guidelines regarding the prevention and management of GC complications in the context of neuromuscular disease, introducing the potential for practice variation, that may compromise quality of care. Our aim was to evaluate the practice patterns among Canadian adult neuromuscular neurologists on the screening, management, and treatment of GC‐related complications and to identify variances in practice.MethodsA web‐based anonymous questionnaire was disseminated to 99 Canadian adult neuromuscular neurologists. Questions addressed patterns of screening, prevention, monitoring, and treatment of GC‐induced adverse events, including infection prophylaxis, vaccination, bone health, hyperglycemia, and other complications.ResultsSeventy‐one percent completed the survey. Of those, 52% perform screening blood work prior to initiating GC, 56% screen for infections, and 18% for osteoporosis. The majority monitor glycemic control and blood pressure (>85%). Thirty‐two (46%) reported that they do not primarily monitor GC complications, but rather provide recommendations to the primary care physician. Pneumocystis jiroveci pneumonia prophylaxis was never used by 29%, and 29% recommend vaccinations prior to GC initiation. Calcium supplementation was recommended by 80% to prevent osteoporosis. Only 36% were aware of any existing guidelines for preventing GC complications, and 91% endorsed a need for neurology‐specific guidelines.DiscussionThere is substantial variability in the management of GC adverse effects among neuromuscular neurologists, often not corresponding to limited published literature. Our results support the need for improved education and neurology‐specific guidelines to help standardize practice and improve and prevent complications.

Publisher

Wiley

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3