Glucocorticoid-Induced Osteoporosis Program (GIOP): a novel, comprehensive, and highly successful care program with improved outcomes at 1 year.

Abstract

INTRODUCTION:

Patients who take chronic glucocorticoids (GC) are at increased risk of osteoporosis and fracture. Only a minority of patients who take chronic GC receive optimal osteoporosis prevention, diagnosis, and/or treatment.

METHODS:

An organized program of care--GIOP (Glucocorticoid-Induced Osteoporosis Program)--was designed and implemented. The program goals were to identify patients at risk of fracture, provide education, redesign and implement new pathways of care, and monitor outcomes. Two hundred chronic GC users were seen at baseline, and follow-up visits scheduled at 6 months and 1 year.

RESULTS:

Patient retention of knowledge, frequent exercise, and 25-OH Vitamin D levels all significantly improved at 1 year. A significant decrease in GC dose was seen. In terms of adherence, 91% of patients considered at high risk were taking a bisphosphonate or teriparatide at 1 year, and 96% of patients overall were adherent to their prescribed regimen of calcium, vitamin D, and prescription treatment (if indicated). Bone density at the spine and total hip increased significantly.

CONCLUSIONS:

GIOP is the first organized program of care for patients who take chronic GC that has demonstrated a clinically significant improvement in outcome. The program's design can be adapted and used by other health systems and organizations.

• Authors: E D Newman, C K Matzko, T P Olenginski, J L Perruquet, T M Harrington, G Maloney-Saxon, T Culp, G C Wood
• Journal: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (Osteoporos Int) Vol. 17 Issue 9 Pg. 1428-34 ( 2006) ISSN: 0937-941X [Print] England
• PMID: 16865312 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Bone Density Conservation Agents
• Glucocorticoids
• Vitamin D

Topics

• Adult
• Aged
• Aged, 80 and over
• Bone Density Conservation Agents (therapeutic use)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Exercise
• Female
• Follow-Up Studies
• Glucocorticoids (adverse effects)
• Humans
• Male
• Middle Aged
• Osteoporosis (chemically induced, drug therapy)
• Outcome and Process Assessment, Health Care
• Patient Compliance
• Program Evaluation
• Vitamin D (blood)