Patients not taking a previously prescribed bone active medication now prescribed medication through Ontario FLS.
Fracture liaison service
Fracture risk
Fragility fracture
Medication adherence
Medication initiation
Journal
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
ISSN: 1433-2965
Titre abrégé: Osteoporos Int
Pays: England
ID NLM: 9100105
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
30
12
2021
accepted:
23
05
2022
pubmed:
29
6
2022
medline:
19
10
2022
entrez:
28
6
2022
Statut:
ppublish
Résumé
In an Ontario fracture liaison service (FLS), we compared medication prescription rates among patients not taking a previously prescribed bone active medication to those with no previous prescription. Prescription rates were similar between these two groups of patients. The FLS provided a secondary opportunity for patients to initiate bone active medication. We compared bone active medication prescription rates among patients presenting to an Ontario fracture liaison service (FLS) who reported not taking a previously prescribed bone active medication to those with no history of prescription. Eligible patients were those screened in 39 fracture clinics between July 1, 2017, and September 15, 2019, who were not taking bone active medication at the time of screening and classified as high risk for future fracture based on CAROC or FRAX. Sociodemographic and clinical risk factor variables were assessed at screening. Bone active medication prescription rate was assessed within 6 months of screening and defined as having received a prescription for the medication from either a specialist or primary care provider. In cases where a specialist report was not available, patient self-reported data were collected. The chi-square test of independence was used to assess differences in prescription rates. Of 17,575 patients screened, eligible patients were 350 with a previous prescription and 2644 without a previous prescription. Compared with patients who reported no previous prescription, those who had a previous prescription were older, more likely to be female and to report a previous fracture, and less likely to smoke. There was no statistically significant difference between the medication prescription rate of patients with a previous prescription (73.7%) compared to patients with no previous prescription (70.7%) (p = 0.157). A large jurisdiction-wide FLS approach provided a secondary opportunity to patients who were not taking a previously prescribed bone active medication to initiate that medication.
Identifiants
pubmed: 35763074
doi: 10.1007/s00198-022-06446-3
pii: 10.1007/s00198-022-06446-3
doi:
Substances chimiques
Bone Density Conservation Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2435-2440Informations de copyright
© 2022. International Osteoporosis Foundation and National Osteoporosis Foundation.
Références
Reynolds K, Muntner P, Cheetham TC et al (2013) Primary non-adherence to bisphosphonates in an integrated healthcare setting. Osteoporos Int 24:2509–2517
doi: 10.1007/s00198-013-2326-5
Burden AM, Paterson JM, Solomon DH, Mamdani M, Juurlink DN, Cadarette SM (2012) Bisphosphonate prescribing, persistence and cumulative exposure in Ontario, Canada. Osteoporos Int 23:1075–82
doi: 10.1007/s00198-011-1645-7
Papaioannou A, Kennedy CC, Dolovich L, Adachi JD (2007) Patient adherence to osteoporosis medications: problems, consequences and management strategies. Drugs Aging 24(1):37–55
doi: 10.2165/00002512-200724010-00003
Papaioannou A, Leslie WD, Morin S et al (2010) 2010 Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. Can Med Assoc J 182(17):1864–1873
doi: 10.1503/cmaj.100771
Mitchell PJ, Cooper C, Fujita M et al (2019) Quality improvement initiatives in fragility fracture care and prevention. Curr Osteoporos Rep 17:510–520
doi: 10.1007/s11914-019-00544-8
Wu C-H, Tu S-T, Chang Y-F et al (2018) Fracture liaison services improve outcomes of patients with osteoporosis-related fractures: a systematic literature review and meta-analysis. Bone 111:92–100
doi: 10.1016/j.bone.2018.03.018
Saunders H, Sujic R, Bogoch E et al (2021) Cost-utility of the Ontario fracture screening and prevention program. J Bone Joint Surg (Am) 103(13):1175–1183
doi: 10.2106/JBJS.20.00795
Ansari H, Beaton D, Sujic R et al (2017) Equal treatment: no evidence of gender inequity in osteoporosis management in a coordinator-based fragility fracture screening program after fracture risk adjustment. Osteoporos Int 28(12):3401–3406
doi: 10.1007/s00198-017-4206-x
Sale JEM, Yang A, Elliot-Gibson V et al (2021) Patients 80+ have similar medication initiation rates to those 50–79 in Ontario FLS. Osteoporos Int 32:1405–1411
doi: 10.1007/s00198-020-05796-0
Siminoski K, Leslie WD, Frame H et al (2005) Recommendations for bone mineral density reporting in Canada. Can Assoc Radiol J 56(3):178–188
pubmed: 16144280
Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA (2010) Independent clinical validation of a Canadian FRAX tool: fracture prediction and model calibration. J Bone Min Res Off J Am Soc Bone Min Res 25(11):2350–8
doi: 10.1002/jbmr.123
Agresti A (2003) Categorical data analysis. John Wiley & Sons, Hoboken, New Jersey
Rice JA (2006) Mathematical statistics and data analysis. Thompson Higher Education, Belmont, CA
Tripepi G, Jager KJ, Dekker FW, Wanner C, Zoccali C (2007) Measures of effect: relative risks, odds ratios, risk difference, and ‘number needed to treat.’ Kidney Int 72(7):789–791
doi: 10.1038/sj.ki.5002432
Pickering RM (2017) Describing the participants in a study. Age Ageing 46:576–581
doi: 10.1093/ageing/afx054
Yu J, Brenneman SK, Sazonov V, Modi A (2015) Reasons for not initiating osteoporosis therapy among a managed care population. Patient Prefer Adherence 9:821–830
pubmed: 26150702
pmcid: 4480594
Sale J, Gignac M, Hawker G et al (2011) Decision to take osteoporosis medication in patients who have had a fracture and are ‘high’ risk for future fracture. BMC Musculoskelet Disord 12:92
doi: 10.1186/1471-2474-12-92
Sale JE, Beaton D, Posen J, Bogoch E (2013) Medication initiation rates are not directly comparable across secondary fracture prevention programs: reporting standards based on a systematic review. J Clin Epidemiol 66(4):379–85.e4
doi: 10.1016/j.jclinepi.2012.10.013
Ganda K, Puech M, Chen JS, Speerin R et al (2013) Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int 24:393–406
doi: 10.1007/s00198-012-2090-y
Sale JEM, Beaton D, Posen J, Elliot-Gibson V, Bogoch E (2011) Systematic review on interventions to improve osteoporosis investigation and treatment in fragility fracture patients. Osteoporos Int 22(7):2067–2082
doi: 10.1007/s00198-011-1544-y
Silverman SL, Siris E, Kendler DL et al (2015) Persistence at 12 months with denosumab in postmenopausal women with osteoporosis: interim results from a prospective observational study. Osteoporos Int 26:361–372
doi: 10.1007/s00198-014-2871-6