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Osteoporosis International

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Open Access 01-01-2014 | Original Article

Increase in prophylaxis of glucocorticoid-induced osteoporosis by pharmacist feedback: a randomised controlled trial

Authors: C. Klop, F. de Vries, T. Vinks, M. J. Kooij, T. P. van Staa, J. W. J. Bijlsma, A. C. G. Egberts, M. L. Bouvy

Published in: Osteoporosis International | Issue 1/2014

Abstract

Summary

The aim of this study was to determine whether feedback by pharmacists to prescribers of patients eligible for glucocorticoid-induced osteoporosis prophylaxis would stimulate the prescribing of osteoporosis prophylaxis. The intervention did not significantly increase the prescribing of bisphosphonates in the total study population, but a significant increase was seen in men and in the elderly. However, the proportion of bisphosphonate-treated patients remained low.

Introduction

The aim of this study was to determine whether feedback by pharmacists to prescribers of patients eligible for glucocorticoid-induced osteoporosis prophylaxis (GIOP) would stimulate the implementation of the Dutch GIOP guideline.

Methods

This randomised controlled trial included 695 patients who were dispensed ≥675 mg prednisone equivalents without a concomitant bisphosphonate prescription within 6 months before baseline. Pharmacists were asked to contact the physicians of GIOP-eligible patients in the intervention group to suggest osteoporosis prophylaxis. The primary endpoint was a bisphosphonate prescription. Secondary endpoints were a prescription of calcium supplements, vitamin D or any prophylactic osteoporosis drug (bisphosphonate, calcium supplements, vitamin D).

Results

The group assigned to the intervention was slightly younger than the control group (68.7 ± 15.4 vs. 65.9 ± 16.9 years, p = 0.02) and used hydrocortisone more often (7.0 % vs. 3.1 %, p = 0.02). Within 6 months, the intervention did not significantly increase the prescribing of bisphosphonates (11.4 % after intervention vs. 8.0 % for controls; hazard ratio [HR] 1.47, 95 % confidence interval [CI] 0.91–2.39). However, subgroup analyses showed a significant increase for the primary endpoint in men (12.8 % vs. 5.1 %, HR 2.53, 95 % CI 1.11–5.74) and patients ≥70 years (13.4 % vs. 4.9 %, HR 2.88, 95 % CI 1.33–6.23). The prescribing of calcium and vitamin D was not significantly altered.

Conclusion

This study showed that active identification of patients eligible for GIOP by pharmacists did not significantly increase the prescribing of bisphosphonates in the total study population, but there was an increase in men and the elderly. However, the proportion of GIOP-treated patients remained low.

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Title: Increase in prophylaxis of glucocorticoid-induced osteoporosis by pharmacist feedback: a randomised controlled trial
Authors: C. Klop
F. de Vries
T. Vinks
M. J. Kooij
T. P. van Staa
J. W. J. Bijlsma
A. C. G. Egberts
M. L. Bouvy
Publication date: 01-01-2014
Publisher: Springer London
Published in: Osteoporosis International / Issue 1/2014
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-013-2562-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Increase in prophylaxis of glucocorticoid-induced osteoporosis by pharmacist feedback: a randomised controlled trial

Abstract

Summary

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

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