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Cited by 19Patient-Provider Communication in HealthcarePharmacy and Medical PracticesMedication Adherence and Compliance

Long-term corticosteroid use and dietary advice: a qualitative analysis of the difficulties encountered by patient

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Nogué, Muriel, Rambaud, Jacques, Fabre, Sylvie, Filippi, Nathalie, Jorgensen, Christian, Pers, Yves-Marie·2019·BMC Health Services Research
DOI 10.1186/s12913-019-4052-yPMC PMC6486686
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Abstract

BACKGROUND: Nearly 1% of the population is currently treated with long-term corticosteroid therapy. When corticosteroids are introduced, information concerning potential adverse effects and recommendations for lifestyle changes aimed at preventing such effects is provided to patients. However, studies have shown patients often do not fully comprehend the information provided and have difficulty implementing the recommended dietary and physical activity advice. In this study, we aim to highlight the difficulties encountered by patients in comprehending and implementing recommendations in the context of long-term corticosteroid use. Such information can be used to better optimize care, particularly concerning adherence to the treatment, the diet, and thus improve the quality of life of patients. METHODS: We recruited adult patients under long-term corticosteroid (≥ 3 months, ≥ 5 mg/day) treatment from both general medicine and rheumatology practices. We performed a qualitative analysis based on semi-structured interviews of these patients. Transcripts of these interviews were then compiled and analysed using a thematic approach. RESULTS: Sixteen patients were included. Analysis of the interviews revealed that patients' hope for effective corticosteroid treatment was counterbalanced by concerns over potential adverse effects. In some patients, the need to respect a strict and imposed diet induced psychological distress, potentially leading to eating disorders or fear of social exclusion. Furthermore, patient ambivalence toward the therapeutic education was highlighted, as well as the notion of filtering information, conscious or unconscious, as revealed by their lack of recall. The relationship with the physician also affected the treatment experience. CONCLUSION: Our analysis of the personal experience of patients regarding recommended lifestyle changes associated with long-term corticosteroid treatment highlights patient difficulties and suggests different ways of improving therapeutic education.

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  • Salt reduction is not indicated as primary prevention of arterial hypertension in patients with corticosteroid therapy.

    “The salt reduction is not”

    From ESPEN guideline on hospital nutrition (2021) · cites this paper as [165]

    The Background (page unavailable) says salt reduction is among the dietary advice given to patients on corticosteroids, but that there are no official recommendations and evidence of efficacy is lacking. The Discussion (page unavailable) likewise says the effectiveness of strict low-salt advice has not been scientifically proven. Neither passage establishes the stronger claim that salt reduction is not indicated specifically for primary prevention of arterial hypertension. (LLM, conf=0.84)

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Sorted by citations

Authors
Nogué, M., Rambaud, J., Fabre, S., Filippi, N., Jorgensen, C., & Pers, Y.-M.
Affiliations
  • Centre Hospitalier Universitaire de Montpellier (FR)
  • Université de Montpellier (FR)
Corresponding author
Nogué, Muriel
ORCID
Pers, Yves-Marie
Venue
BMC Health Services Research
Publisher
Springer Science and Business Media LLC
Published
2019-04-26
Volume
19
Issue
1
Pages
255-255
ISSN
1472-6963 (ISSN-L)
DOI
10.1186/s12913-019-4052-y
PMC
PMC6486686
OpenAlex
W2940630884
Cited by
19
References
2
Citations by year
2026: 2 · 2025: 3 · 2024: 5 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 1
FWCI
2.39
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Health Services Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, cc-by)
  • HAL (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Keywords
long-term corticosteroid therapy, dietary recommendations, lifestyle modification, patient understanding, medication adherence, corticosteroid adverse effects, psychological distress, eating disorders, social exclusion, therapeutic education, physician-patient relationship, rheumatology patients, patient experience
MeSH terms
Healthy Lifestyle, Adrenal Cortex Hormones, Adult, Aged, Aged, 80 and over, Counseling, Diet, Female, Humans, Long-Term Care, Male, Middle Aged, Patient Education as Topic, Physician-Patient Relations, Quality of Life, Exercise, Young Adult

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