Patients in chronic prednisone use in a Brazilian municipality: are potential adverse events being monitored?

Abstract

Introduction: chronic use of corticosteroids can trigger several adverse effects with changes in glycemic, lipid, liver enzymes and electrolyte levels. Therefore, the the aim of the present study was to analyze if the patients on chronic prednisone use from the Brazilian Public Health System (PHS) in a Midwestern municipality of the state of Minas Gerais were monitored for their adverse effects through laboratory tests. Methods: a longitudinal descriptive study was carried out with retrospective data from patients attended by the PHS of this city, and who have used prednisone chronically for three consecutive years, from 2014 to 2016. The frequency of patients who underwent tests to monitor adverse events from the chronic use of prednisone was verified through electronic records in the Integrated Health System (IHS). The following types of tests were analyzed: total serum calcium, urine calcium (24-hour urine), serum phosphate, alkaline phosphatase, fasting glucose, sodium (Na+), potassium (K+), and lipidogram (triglycerides, LDL, VLDL, HDL, and total cholesterol). Results: it was observed that fasting glucose and lipidogram were the tests that presented the highest number of annual records. However, for the other examined parameters, which are essential for the follow-up of patients in chronic use of corticosteroids, the non-monitoring index is greater than 80 %. Conclusions: the results revealed an inadequate frequency of laboratory monitoring of patients in chronic prednisone use, indicating the occurrence of prescriptions without the monitoring of possible adverse effects, which may constitute safety problems for patients.