Perdoncini-Roux A, Blanchon T, Hanslik T, Lasserre A, Turbelin C, Dorleans Y, Cabane J, Fardet L
Service de médecine interne horloge 2, hôpital Saint-Antoine, AP-HP, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
Rev Epidemiol Sante Publique. 2009 Apr;57(2):93-7. doi: 10.1016/j.respe.2008.12.009. Epub 2009 Mar 19.
General practitioners' perception of the discomfort their patients experience because of corticosteroid-induced adverse events is unknown.
An observational epidemiological study was conducted in September 2007. Eight hundred and sixty general practitioners belonging to the réseau Sentinelles were asked to complete an electronical questionnaire. The questionnaire aimed to assess their perception of discomfort induced by adverse events induced by a long-term (i.e.,>or=3 months) corticosteroid therapy among their patients. Results were compared with the declaration made by 115 long-term corticosteroid treated patients followed in an internal medicine department.
Two hundred and ninety-three general practitioners responded to the questionnaire (response rate: 34%). They were predominantly male (87%). Forty-eight percent of them reported 400 to 600 monthly visits. The mean length of corticosteroid therapy for patients was 44+/-38 months and the mean daily dosage was 15+/-14 mg. They suffered mainly from lupus erythematosus (33%) or giant cell arteritis (15%). The adverse events considered to be the most disturbing by patients were lipodystrophy (25%), followed by weight gain (18%) and neuropsychiatric complaints (16%). Physicians widely overestimated the discomfort caused by weight gain cited as the most disturbing adverse event by 59% of them and underestimated that induced by mood disorders cited as the most disturbing by only 3% of them.
The discomfort caused by corticosteroid-induced neuropsychiatric adverse events are underestimated by general practitioners.
全科医生对于患者因皮质类固醇诱导的不良事件所经历的不适的认知尚不清楚。
2007年9月开展了一项观察性流行病学研究。邀请了属于哨兵网络的860名全科医生填写一份电子问卷。该问卷旨在评估他们对于长期（即≥3个月）皮质类固醇治疗在其患者中诱导的不良事件所引起的不适的认知。将结果与在内科接受治疗的115名长期接受皮质类固醇治疗的患者所做的报告进行比较。
293名全科医生回复了问卷（回复率：34%）。他们主要为男性（87%）。其中48%报告每月有400至600次就诊。患者皮质类固醇治疗的平均时长为44±38个月，平均日剂量为15±14毫克。他们主要患有红斑狼疮（33%）或巨细胞动脉炎（15%）。患者认为最困扰的不良事件是脂肪代谢障碍（25%），其次是体重增加（18%）和神经精神方面的不适（16%）。医生普遍高估了被5个9%的医生列为最困扰不良事件的体重增加所引起的不适，而低估了仅被3%的医生列为最困扰的情绪障碍所引起不适。
全科医生低估了皮质类固醇诱导的神经精神不良事件所引起的不适。
