Goupille P et al. - Considerable variations were found among rheumatologists regarding practice patterns for performing shoulder glucocorticoid injections. This variability reflects the absence of official guidelines. Methods
The practice patterns regarding shoulder glucocorticoid injections in pts taking antiplatelet drugs or vitamin K antagonists were studied
Relevant data among rheumatologists in France was collected through postal questionnaire survey
Results
1018 completed questionnaires were received
The proportion of rheumatologists who discontinued drugs with antithrombotic effects prior to shoulder injections varied across drugs
Among rheumatologists who discontinued vitamin K antagonist therapy, 82% prescribed replacement therapy with low-molecular-weight heparin
Time from discontinuation to injection was not consistently appropriate to the duration of drug effects
Prior to the injection, hemostasis tests were obtained by 1% of rheumatologists for pts on NSAIDs, 6% on clopidogrel, and 65% on vitamin K antagonists
Only 1% of rheumatologists had observed bleeding events in pts on aspirin vs 10% in pts on vitamin K antagonists
The mean number of shoulder glucocorticoid injections per rheumatologist per month was 19.6
4% of rheumatologists routinely obtained hemostasis tests before shoulder injections
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