Systemic glucocorticoid prescriptions pattern and factors of inappropriate use in primary care institutions of Southwest China

Bibliographic Data

ID22074176
AuthorsXiaobo Luo (Guiyang Medical University), Shitao Yu (0000-0002-0682-9974, Shanghai Public Health Clinical Center), Zhen Zeng (0000-0001-8481-3567), Xunrong Zhou (0000-0001-8932-333X, corresponding author), Yuxi Liu (0000-0003-2484-151X, Guangdong Medical College, corresponding author), Lei Wang (0000-0001-5326-565X), Gang Wang (0000-0002-2288-3807, Health Commission of Anhui Province), Jiaqi Hu (0000-0002-3319-7167, Guiyang Medical University), Yue Chang (0000-0001-6517-4923, Guiyang Medical University, corresponding author)
Year2022
Volume10
Pages952098-952098
Publication date2022-09-12
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2022.952098
PMID36172212
OpenAlexW4296524690
LanguageEN
References cited70

Background: Inappropriate use of glucocorticoids in primary care institutions is serious. It not only causes economic burden, but leads to many adverse reactions. The purpose of this study is to explore systemic glucocorticoid prescription pattern and factors of inappropriate use in primary care institutions. Methods: This is a retrospective study. Systemic glucocorticoids prescribed in 58 primary care institutions in Guizhou province of Southwest China in 2020 were selected from the Health Information System. All prescriptions were classified as appropriate or inappropriate use. Inappropriate use was classified into the following two categories: (a) Inappropriate indications; (b) Inappropriate selection of glucocorticoids. Multivariate analysis was used to explore the factors associated with inappropriate use of systemic glucocorticoids. Results: A total of 63,315 glucocorticoid prescriptions were included in the analysis. Diseases of the respiratory system (60.8%) and diseases of the skin and subcutaneous tissue (23.1%) were the most common indications for use. Injections (89.8%) predominated and dexamethasone (86.5%) was the most prescribed glucocorticoid. 68.2% of all prescriptions were inappropriate. Compared to physicians with a college degree, physicians with a junior college (OR: 1.12, 95% CI: 1.08-1.17) and technical secondary education (OR: 1.12, 95% CI:1.05-1.19) were more likely to prescribe glucocorticoids inappropriately as were attending physicians (OR: 1.12, 95% CI: 1.01-1.25) and resident physicians (OR: 1.31, 95% CI: 1.15-1.48) compared to associate chief physicians. The risk of inappropriate glucocorticoid use was highest in patients 65 years of age and older (OR: 6.00, 95% CI: 5.62-6.40). In contrast, prescriptions given by injection were more likely to be used inappropriately than those given orally (OR: 0.44, 95% CI: 0.41-0.46). Conclusion: Inappropriate use of systemic glucocorticoids without appropriate indications was extremely prominent in primary care institutions of Guizhou Province, especially in diseases of the respiratory system and among the elderly. The risk of inappropriate glucocorticoid use was highest in patients 65 years of age and older. It is important to note that physicians younger than 33, with more than 40 years of service, and attending or residents were more likely to inappropriately prescribe glucocorticoids

Dexamethasone · Family medicine · Glucocorticoid · Medical prescription · Multivariate analysis · Primary care · Retrospective cohort study · Adrenal Hormones and Disorders · Asthma and respiratory diseases · Health Promotion and Cardiovascular Prevention · Medicine · Emergency Medicine · Internal Medicine · Pediatrics · Pharmacology

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