Assessment of risk and use of prophylaxis for glucocorticoid-induced osteoporosis among dermatologists in the pacific Northwest: A survey study

Objective: There currently exists a wide variation in clinician approach to the assessment and management of glucocorticoid-induced osteoporosis (GIO). Our objectives were to characterize Pacific Northwest dermatology providers’ general practices, assessment of risk for GIO, and preferred GIO prophylaxis measures by way of survey. To identify whether knowledge deficits exist with respect to preventing and managing GIO in dermatology patients. Design: A self-administered, 22-question survey was sent electronically to respondents. Surveyed population composed of 392 dermatology providers of the Washington State Dermatology Association and Oregon Dermatology Society registries. Survey responses were collected anonymously via Catalyst WebQ. Results: Respondents over-estimated fracture risk and reported they would prescribe antiresorptive medications at a less-than-adequate rate. When given clinical scenarios and asked to assess risk of major osteoporot-ic fracture, respondents frequently overestimated risk compared to that estimated by the FRAX tool (67%-71%). When asked directly if one would prescribe bi-sphosphonates as GIO prophylaxis for a high-risk patient, only 49% responded always/almost always. Conclusions: This study suggests that a knowledge deficit exists within dermatology with respect to prevention and screening of GIO. Provider variability in practices suggests that dermatology could benefit from additional education in assessment and treatment of GIO, as well as a clear set of guidelines for GIO management.