Continous Use of Oral Corticosteroid Among Ambulatory Patients in Jember During 2010-2011

Abstract

Prolonged oral corticosteroid use was reported to be associated with several adverse effects, such as fractures and increased risk of developing tuberculosis (TB). This descriptive, prospective study was to observe the pattern of oral corticosteroid use and to find correlation between age, gender, and continuous use of oral corticosteroids in Jember, East Java, Indonesia. Continuous use was defined as receiving more than one oral corticosteroid prescription, and the duration between prescriptions was less than 3 months (90 days). Data were obtained from ambulatory claim database of Asuransi Kesehatan (Askes) of patients aged more than 18 years visiting dr. Soebandi Hospital, Jember from January 1, 2010 to October 31, 2011. Consecutively, 366 oral corticosteroid users were followed until October 31, 2011 starting from the time they received the first prescription. This study found that 14.9% (3,275/2,1907) Askes ambulatory patients accepted oral corticosteroid prescriptions. A number of 44.0% (160/366) patients were continuous users of oral corticosteroid with median (IQR) duration of use of 56 (20.5—133) days. Almost all patients (98.6%, 361/366) received dexamethasone 0.5 mg at a point of time. Multiple linear regression analysis showed positive, statistically significant (p=0.015) correlation between age, gender, interaction of both, and the logarithmic duration of continuous use of oral corticosteroid. Men were more likely to use oral corticosteroid than women after their 53th birthday. In conclusion, concern to prolonged use of oral corticosteroid should be more focused in older males than females in Jember