Use and misuse of glucocorticoids in the community of Raxaul Block, North Bihar

Abstract

Background: Glucocorticoid misuse is widely recognised but inadequately addressed issue in India. This study reports the use and misuse of glucocorticoids in Raxaul Block, North Bihar, India.

Methods: A two-stage sampling method was used to interview 240 households during April and May 2013. In each household, anyone who had been sick in the last 6 months had their medication use recorded.

Results: In total, 113 out of 334 (33·8%) were found to have taken a glucocorticoid in the last 6 months (95% CI: 28.7-38.9%). One hundred (88.4%) of these were considered to be inappropriate. Seventy-nine percent had been using glucocorticoids for more than 1 month; 60.2% were prescribed by local, unlicensed practitioners.

Conclusions: Glucocorticoid misuse will contribute to the burden of hypertension, diabetes, osteoporotic fracture, tuberculosis, cataracts and deaths due to hypoadrenal crisis. One in 15 people in Raxaul Block are likely to have a suppressed hypothalamo-pituitary-adrenal axis.

Keywords: Community; glucocorticoid; misuse.