The all-powerful and 'happy' drug: the use of steroids among primary care doctors in Hong Kong.

BACKGROUND

Steroids are commonly used, but their prescribing pattern and factors associated with their use in the primary care setting are largely unknown.

METHODS

Using diagnosis and drug data obtained from logbooks submitted by participants in the Diploma in Family Medicine course between 1999 and 2004, we selected and analysed all patients with a prescription of steroid as well as conditions in which it was prescribed. Factors, relating to patients or doctors, which could be associated with steroid prescription were recorded for both the prescribed and the non-prescribed groups. The results were compared using chi-square tests.

RESULTS

Steroids were prescribed in 7.1% of all patient encounters, of which dermatological and respiratory diseases were the most two common conditions. Upper respiratory tract infections accounted for a third of all respiratory diseases in which steroid was prescribed. Female or 'minor' patients (OR 1.16, 95% CI 1.01-1.32 and 1.16, 1.00-1.36 respectively) were more likely to be given a steroid and younger doctors (1.52, 1.25-1.86) were more likely to prescribe them.

CONCLUSION

Some patterns of poor prescribing practice were demonstrated in this study. Campaigns by professional bodies may improve prescribing among our community doctors and effective public education programmes are needed to modify the health beliefs and expectations of the general public.