Pharmacist interventions in osteoporosis management: a systematic review

Abstract

Internationally, there is an osteoporosis treatment gap, which pharmacists may assist in closing. This review identifies pharmacist interventions for improving osteoporosis management and evaluates their effectiveness. Pharmacist interventions are shown to improve osteoporosis management in terms of increasing investigation and treatment commencement and osteoporosis therapy adherence. Introduction This review identifies pharmacist interventions for improving osteoporosis management and evaluates their effectiveness. Methods A literature search using PubMed, Embase, International Pharmaceutical Abstracts, and Cumulative Index to Nursing and Allied Health Literature was undertaken from database inception to June 2022. Randomised controlled trials were eligible, if they included adults diagnosed with or at risk of osteoporosis and assessed pharmacist interventions to improve osteoporosis management. Outcomes regarding investigation, treatment, adherence and patient knowledge were evaluated using qualitative analysis. The quality of included studies was assessed using the Critical Appraisal Skills Programme checklists and the Cochrane Collaboration tool to assess the risk of bias (Rob 2.0). Results Sixteen articles (12 different studies) with a total of 16,307 participants, published between 2005 and 2018 were included. Pharmacist interventions were classified into two categories, those targeting investigation and treatment (n = 10) and those targeting adherence (n = 2). The impact of the intervention on patient knowledge was considered by studies targeting both investigation and treatment (n = 2) and adherence (n = 1). Pharmacist interventions demonstrated benefit for all outcomes; however, the extent to which conclusions can be drawn on their effectiveness is limited by the heterogeneity of interventions employed and methodological issues identified. Patient education and counselling were identified as a cornerstone of pharmacist interventions targeting both investigation and treatment and adherence, along with the importance of pharmacist and physician collaboration. Conclusion Pharmacist interventions show promise for improving osteoporosis management. The potential for pharmacists to contribute to closing the osteoporosis treatment gap through undertaking population screening has been identified.

Perceptions and practices of aged care pharmacists regarding osteoporosis management: a qualitative study

“…Consequently, aged care resident-specific fracture risk assessment tools to guide management have been developed [ 16 , 37 ]. Completing fracture risk assessment tools and participating in case conferences that enable clinical discussion are examples of a non-dispensing service embedded pharmacists could undertake as part of an interdisciplinary team to improve osteoporosis management [ 29 ].…”

“…A recent systematic literature review found that pharmacists undertaking non-dispensing services can improve osteoporosis management [ 29 ]. Utilising these services, pharmacists increased osteoporosis investigation, treatment commencement and adherence [ 29 ].…”

“…A recent systematic literature review found that pharmacists undertaking non-dispensing services can improve osteoporosis management [ 29 ]. Utilising these services, pharmacists increased osteoporosis investigation, treatment commencement and adherence [ 29 ]. However, this literature review identified that there is limited evidence regarding pharmacist interventions for osteoporosis in the aged care setting [ 29 ].…”

“…Utilising these services, pharmacists increased osteoporosis investigation, treatment commencement and adherence [ 29 ]. However, this literature review identified that there is limited evidence regarding pharmacist interventions for osteoporosis in the aged care setting [ 29 ]. It is theorised that pharmacists undertaking non-dispensing services can improve osteoporosis management for aged care residents.…”

Safer medicines To reduce falls and refractures for OsteoPorosis (#STOP): a study protocol for a randomised controlled trial of medical specialist-initiated pharmacist-led medication management reviews in primary care

“…This is likely due to lack of awareness and robust evidence to support the role of collaborative medication reviews for patients with minimal trauma fracture. Indeed, recent systematic reviews reporting pharmacist interventions for patients with osteoporosis highlighted a range of interventions but no studies included pharmacist-led medication reviews 56 57. This trial is intended to determine whether incorporating collaborative medication reviews in the transition between tertiary care and primary care can optimise medication management for patients with minimal trauma fracture.…”