Clinical audit on evaluating situations where patients are prescribed long-term steroids without appropriate monitoring for adverse effects such as osteoporosis, diabetes, or adrenal suppression

Abstract

Chronic inflammatory diseases are better managed with long-term steroid therapy. Nevertheless, it predisposes the patient to numerous complications if not monitored properly. The current clinical audit was carried out at the Emergency Lady Reading Hospital to check on the adequacy of monitoring practices of prolonged steroid use. In particular, the study focused on preventing adverse effects such as osteoporosis, diabetes, and adrenal suppression, which remain significantly high but are largely unaddressed in many clinical settings. The audit focused on a 54-year-old male patient under treatment for chronic obstructive pulmonary disease and rheumatoid arthritis, who was managed under long-term prednisone therapy for 8 years. The patient presented symptoms as severe fatigue, muscle weakness, and bone pain, which could be interpreted as indicative of adrenal insufficiency and osteoporosis. These were once again confirmed by the diagnostic tests, which again revealed a very critical gap in monitoring and managing his steroid therapy.  In this way, key recommendations include the need for periodic screening of bone density and adrenal function, and patient education on the risks of steroid use,  it would be of great importance in ensuring the safety of patients and increasing the approaches to treatment to prevent these cases in the future.