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Prednisone Prescribing on the Rise

medscape-article

ANAHEIM, California — The number of prescriptions for prednisone has been increasing steadily since 2000 in the United States, and not all prescriptions are appropriate, researchers reported in a poster session here at the American College of Allergy, Asthma & Immunology 2012 Annual Scientific Meeting.

I have been in residency for the past 3 and a half years, and was surprised at the amount of steroids being prescribed and the diseases they were being prescribed for,” Tricia Lee, MD, 2012 chief resident in internal medicine and pediatrics at the University of Louisville in Kentucky, told Medscape Medical News.

This impressed me because we are taught in medical school about all of the significant side effects of systemic steroids, which include weight gain, thinning of skin, psychiatric changes, and adrenal suppression.

I wanted to see if we, as physicians, were truly prescribing more prednisone now than we were a few years ago,” Dr.

Lee explained.

She and her group examined data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey databases, which were collected by the Centers for Disease Control and Prevention, from 2000 to 2009.

During that time, 11 billion visits were recorded in the 2 databases.

Prednisone was prescribed in 178,655,280 visits for any diagnosis — an increase of 17% for all ages.

For adults, prednisone was prescribed 13% more frequently in 2009 than it was in 2000; for children, it was prescribed 38% more frequently, Dr.

Lee said.

Diagnoses Associated With Prednisone Prescription More than 1000 different primary diagnoses were associated with a prescription for prednisone.

Asthma, allergy, bronchitis, rheumatoid arthritis, urticaria, contact dermatitis, acute upper respiratory infections, and pneumonia accounted for the majority of prescriptions.

For allergic rhinitis, prednisone prescriptions increased from 1.

Dr.

Lee noted.

The worry is that a patient will go to one doctor to get a prescription for prednisone for his rheumatoid arthritis, go to another to get prednisone for a pain in his shoulder, go to another to get a prescription for his asthma, and so on, until he is taking a dangerous amount of prednisone, without all of his doctors being aware,” Dr.

Lee said.

The danger to the patient is that, in the span of a few months, they may be exposed to steroids for a chronic period,” she said.

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