Detección de osteoporosis en mujeres posmenopáusicas en farmacia comunitaria

Abstract

(QUI) and to value the medical intervention after the determination of the bone mineral density (BMD). Methods: Cross-sectional descriptive study developed in a community pharmacy. During the month of June of 2005 the community pharmacy enrolled postmenopausal women into the study. Women in treatment with calcium, vitamin D, hormone replacement therapy, estrogen receptor modulators, calcitonin or biphosphonates were considered criteria for exclusion. To all the women that consent to participate, the pharmacist measured BMD with the device Sahara Hologic Ultrasound Bone Densitometer at right calcaneus. Following the World Health Organization, women were classified as osteoporotic if their T-Score was less than -2.5 and as osteopenic if their T-Score ranged between -2.5 and -1.0. Results: Of the 100 women screened, 11 (11%) presented risk of osteoporosis and 61 (61%) of osteopenia. The 18.5% postmenopausal women with body mass index lesser than 30 presented risk of osteoporosis and the 63.0% osteopenia. Conclusions: The QUI constitutes a useful tool in community pharmacy for the screening of osteoporosis and it supposes a greater integration of the community pharmacy within the health care. Keywords RESUMENObjetivos: Identificar mujeres posmenopáusicas con riesgo de osteoporosis mediante ultrasonografía ósea cuantitativa y valorar la intervención médica tras la determinación de la densidad mineral ósea. Métodos: Estudio descriptivo transversal desarrollado en una farmacia comunitaria mediante la selección de las mujeres posmenopáusicas que acudieron durante el mes de junio de 2005. Se consideró criterio de exclusión estar en tratamiento con calcio, vitamina D, terapia hormonal sustitutiva, raloxifeno, calcitonina o bifosfonatos. A todas las mujeres que acceden a participar se les realizó un ultrasonografía ósea en el calcáneo derecho con el dispositivo Sahara (Hologic). Se aplicaron los criterios de clasificación de la Organización Mundial de la Salud, que clasifican a los pacientes con una DMO de más de 2,5 desviación estándar inferior a la media de una adulto joven (T-Score < -2,5) como osteoporótico, y a los pacientes con T-Score entre -1 y -2,5 como osteopénicos. Resultados: De las 100 mujeres estudiadas, 11 (11%) presentaban riesgo de osteoporosis y 61 (61%) riesgo de osteopenia. El 18,5% de las mujeres con un índice de masa corporal < 30 presentaba riesgo de osteoporosis y el 63% osteopenia. Conclusiones: La ultrasonografía ósea cuantitativa constituye una herramienta útil en farmacia comunitaria para el cribado de osteoporosis y supone una nueva vía de integración en la atención sanitaria.Palabras clave: Osteoporosis. Osteopenia. Cribado. Ultrasonografía. España. (English) INTRODUCTIONOsteoporosis is a systemic disease of the skeleton, characterised by low bone mass and alterations in the micro-architecture of the bone tissue that lead to an increase in brittleness with the ensuing predisposition to bone fractures.1 In 1994 the World Health Organisation (WHO) established diagnostic criteria based on the ...

A systematic review of community pharmacy interventions to improve peri- and post-menopausal health

“…The characteristics of the included studies are summarised in Table 2 . Blundell et al was a cross sectional study conducted in a single setting in Spain, 24 while Zeolla et al conducted a multi-centre study in the United States. 25 Blundell et al aimed to identify post-menopausal women accessing community pharmacies who were at risk of developing OP by using quantitative bone ultrasound and to evaluate the effectiveness of medical intervention after determining bone density.…”

“… 25 Blundell et al aimed to identify post-menopausal women accessing community pharmacies who were at risk of developing OP by using quantitative bone ultrasound and to evaluate the effectiveness of medical intervention after determining bone density. 24 Zeolla et al focused on evaluating the outcomes of a community pharmacy-based menopause education programme. 25 Women in both studies ranged in age between 47 and 83 years with the majority post-menopausal.…”

“…The number of years of amenorrhoea ranged from 0 to 36 years in the study of Blundel et al Both studies received global ratings of 'weak'. Both studies scored 'strong' in just one domain: withdrawals and dropouts 24 or data collection methods. 25 Blundell et al scored 'moderate' for selection bias.…”

“…Participants were also asked to fill in a questionnaire to assess their satisfaction with the service provided by the community pharmacy. 24 Community pharmacists in Zeolla et al's study participated in a comprehensive education curriculum provided by the investigators, which was designed to provide the pharmacists with information about short-and long-term consequences of the menopause in addition to a review of pharmacologic and non-pharmacological treatment options. A checklist, devised by the pharmacists and investigators, was utilised to guide pharmacists through the patient education session.…”

“…Of those who completed the satisfaction questionnaire (87%), 64.4% thought the explanation of the test results by pharmacists was excellent, while 74.7% rated the pharmacists' treatment as excellent. 24 The MoM survey in Zeolla et al's study yielded an overall composite score (maximum 100 points) and 3 subscores: exposure to counselling, breadth of counselling and personalisation of counselling. Compared with baseline scores, median 3-month scores were significantly increased for all survey components, including the composite score (p < .001).…”