An Evaluation of Managing and Educating Patients on the Risk of Glucocorticoid-Induced Osteoporosis

McDonough, Randy P.; Doucette, William R.; Kumbera, Patty; Klepser, Donald G.

doi:10.1111/j.1524-4733.2005.04007.x

Cited by 39 publications

(67 citation statements)

References 39 publications

(50 reference statements)

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“…These RCTs were conducted by various healthcare professionals such as primary care physicians,(53, 54) orthopaedic surgeons, (55,54) pharmacists (38)(39)(40) and nurses. (56).…”

Section: Discussionmentioning

confidence: 99%

“…However, two of these studies were considered biased (41). Nonetheless, all three studies provided attestation that the intervention of pharmacists increased the number of patients that had their BMD tested and calcium intake initiated, indicating that pharmacists may have a role to play in reducing the gap in osteoporosis management (38)(39)(40). To date, there is no osteoporosis screening program in Malaysia.…”

Section: Introductionmentioning

confidence: 99%

“…Although, most pharmaceutical care services are mainly targeted at treatment of osteoporosis. A further literature search revealed that there are three randomized control trials (RCTs) conducted by community pharmacies in Canada, Australia and US to evaluate the impact of pharmacist's interventions on osteoporosis management (38)(39)(40). However, two of these studies were considered biased (41).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

An analysis of inter-professional collaboration in osteoporosis screening at a primary care level using the D'Amour model

Toh

Lai

Othman

et al. 2017

Research in Social and Administrative Pharmacy

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Objective: To develop a pharmacist-led osteoporosis screening intervention based on interviews with stakeholders.Methods: Nurses(n=10), pharmacists(n=11), doctors(n=10), patients(n=20) and policy makers(n=5) from a primary care clinic in Malaysia, were individually interviewed using a semi-structured topic guide. Purposive sampling was used to ensure a maximum variation sample. Interviews were transcribed verbatim and analysed using thematic analysis. The themes which emerged within each group were similar and the analysis of all the stakeholders were combined. The behavioural change wheel (BCW) was used as it draws on relevant theories to guide the selection of interventions that are most likely to be effective.Results: Several barriers were identified: governmental, organisational, work environment, team, individual, tasks and patient factors. We decided to develop our intervention based on patient factors as these directly influence practice and outcomes. The main patient factor was their nonchalant attitude towards osteoporosis, it was perceived to be a non-life threatening disease. Hence, our intervention consisted of: an assessment of patients' osteoporosis risk by the pharmacist whilst the patients are waiting for the doctor's appointment, an education session, and restructuring of the current practice which incorporates this intervention into daily clinic practice. Subsequently, a recommendation to the doctor was made for a bone mineral density scan when necessary.Conclusions: This is the first study to use the Behaviour Change Wheel study to develop an osteoporosis screening intervention. The BCW assisted the development of a pharmacist-led osteoporosis screening intervention. This intervention will be evaluated for its feasibility in a future study

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“…These RCTs were conducted by various healthcare professionals such as primary care physicians,(53, 54) orthopaedic surgeons, (55,54) pharmacists (38)(39)(40) and nurses. (56).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An analysis of inter-professional collaboration in osteoporosis screening at a primary care level using the D'Amour model

Toh

Lai

Othman

et al. 2017

Research in Social and Administrative Pharmacy

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“…Reminder Plus Education With or Without Risk Assessment (Table 5; eight studies) [34][35][36][37][38][40][41][42] Six RCTs included a reminder plus education as part of the intervention. Of these, three studies that showed an improvement in outcomes targeted the reminder component of the intervention to both physicians and patients [34][35]42 .…”

Section: Sources Of Heterogeneitymentioning

confidence: 99%

“…Of these, 1,246 citations were screened for relevance, 42 articles were selected for full-text review, and 13 RCTs met the inclusion/exclusion criteria and were included in the systematic review [30][31][32][33][34][35][36][37][38][39][40][41][42] …”

Section: Full-text Review Of Potentially Relevant Rcts (N = 42)mentioning

confidence: 99%

Clinical Decision Support Tools for Osteoporosis Disease Management: A Systematic Review of Randomized Controlled Trials

Kastner

Straus

2008

J GEN INTERN MED

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Challenges in Improving the Quality of Osteoporosis Care for Long-term Glucocorticoid Users

Curtis

Westfall²,

Allison³

et al. 2007

Arch Intern Med

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Background: In light of widespread undertreatment for glucocorticoid-induced osteoporosis (GIOP), we designed a group randomized controlled trial to increase bone mineral density (BMD) testing and osteoporosis medication prescribing among patients receiving longterm glucocorticoid therapy.Methods: Using administrative databases of a large US health plan, we identified physicians who prescribed longterm glucocorticoid therapy to at least 3 patients. One hundred fifty-three participating physicians were randomized to receive a 3-module Web-based GIOP intervention or control course. Intervention modules focused on GIOP management and incorporated case-based continuing medical education and personalized audit and feedback of GIOP management compared with that of the top 10% of study physicians. In the year following the intervention, we compared rates of BMD testing and osteoporosis medication prescribing between intervention and control physicians.Results: Following the intervention, intent-to-treat analyses showed that 78 intervention physicians (472 patients) vs 75 control physicians (477 patients) had simi-lar rates of BMD testing (19% vs 21%, P = .48; rate difference, −2%; 95% confidence interval [CI], −8% to 4%) and osteoporosis medication prescribing (32% vs 29%, P=.34; rate difference, 3%; 95% CI, −3% to 9%). Among 45 physicians completing all modules (343 patients), intervention physicians had numerically but not significantly higher rates of BMD testing (26% vs 16%, P =.04; rate difference, 10%; 95% CI, 1%-20%) and bisphosphonate prescribing (24% vs 17%, P=.09; rate difference, 7%; 95% CI, −1% to 16%) or met a combined end point of BMD testing or osteoporosis medication prescribing (54% vs 44%, P =.07; rate difference, 10%; 95% CI, −1% to 21%) compared with control physicians. Conclusions:In the main analysis, a Web-based intervention incorporating performance audit and feedback and case-based continuing medical education had no significant effect on the quality of osteoporosis care. However, dose-response trends showed that physicians with greater exposure to the intervention had higher rates of GIOP management. New cost-effective modalities are needed to improve the quality of osteoporosis care.

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An Evaluation of Managing and Educating Patients on the Risk of Glucocorticoid-Induced Osteoporosis

Abstract: Community pharmacists are capable of increasing calcium supplementation among patients at risk for glucocorticoid-induced osteoporosis. Pharmacists who educate at-risk patients can impact the self-care of these patients.

Cited by 39 publications

References 39 publications

An analysis of inter-professional collaboration in osteoporosis screening at a primary care level using the D'Amour model

An analysis of inter-professional collaboration in osteoporosis screening at a primary care level using the D'Amour model

Clinical Decision Support Tools for Osteoporosis Disease Management: A Systematic Review of Randomized Controlled Trials

Challenges in Improving the Quality of Osteoporosis Care for Long-term Glucocorticoid Users

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