Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study

Objective To determine the frequency of prescriptions for short term use of oral corticosteroids, and adverse events (sepsis, venous thromboembolism, fractures) associated with their use.Design Retrospective cohort study and self controlled case series.Setting Nationwide dataset of private insurance...

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Bibliographic Details
Published in:	BMJ (Online) 2017-04, Vol.357, p.j1415-j1415
Main Authors:	Waljee, Akbar K, Rogers, Mary A M, Lin, Paul, Singal, Amit G, Stein, Joshua D, Marks, Rory M, Ayanian, John Z, Nallamothu, Brahmajee K
Format:	Article
Language:	eng
Subjects:	Administration, Oral Adrenal Cortex Hormones - administration & dosage Adrenal Cortex Hormones - adverse effects Adult Chronic illnesses Codes Cohort Studies Comorbidity Dose-Response Relationship, Drug Drug dosages Drug-Related Side Effects and Adverse Reactions - classification Drug-Related Side Effects and Adverse Reactions - epidemiology Drug-Related Side Effects and Adverse Reactions - etiology Ethnicity Female Fractures Hospitals Humans Incidence Male Middle Aged Patients Pharmacy Population Practice Patterns, Physicians' - statistics & numerical data Prescriptions Retrospective Studies Rheumatoid arthritis Risk Assessment Sepsis Steroids Thromboembolism Time Factors United States - epidemiology
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Summary:	Objective To determine the frequency of prescriptions for short term use of oral corticosteroids, and adverse events (sepsis, venous thromboembolism, fractures) associated with their use.Design Retrospective cohort study and self controlled case series.Setting Nationwide dataset of private insurance claims.Participants Adults aged 18 to 64 years who were continuously enrolled from 2012 to 2014.Main outcome measures Rates of short term use of oral corticosteroids defined as less than 30 days duration. Incidence rates of adverse events in corticosteroid users and non-users. Incidence rate ratios for adverse events within 30 day and 31-90 day risk periods after drug initiation.Results Of 1 548 945 adults, 327 452 (21.1%) received at least one outpatient prescription for short term use of oral corticosteroids over the three year period. Use was more frequent among older patients, women, and white adults, with significant regional variation (all P
ISSN:	0959-8138 1756-1833