Pharmacist Screening for Risk of Osteoporosis in Elderly Veterans

Salvig, Brent E.; Gulum, Alev H.; Walters, Stephanie A.; Edwards, Leigh; Fourakre, T. Neal; Marvin, Susan C.; McKenzie, Michael S.; Moseley, Michelle V.; Ansari, Ishrat J.

doi:10.4140/tcp.n.2016.440

Cited by 4 publications

(5 citation statements)

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“…Clinical pharmacists performed clinical pharmacy activities through participating in clinical rounds and providing reasonable medication recommendations to support the MDT with a focus on identification, prevention, and resolution of DRPs to improve patient outcomes. Many studies had shown that clinical pharmacists played a crucial role in medication therapy management services in patients with osteoporosis by a multidisciplinary approach [ 21 , 22 ]. For patients, medication education provided by clinical pharmacists was more conducive to solve the DRPs in the process of pharmacotherapy [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Application of comprehensive pharmaceutical care program in identifying and addressing drug-related problems in hospitalized patients with osteoporosis

Chen

Zhang

José

et al. 2022

BMC Health Serv Res

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Background More information about the impacts of comprehensive pharmaceutical care program (CPCP) on the identification and resolution of drug-related problems (DRPs) is needed. This study aimed at researching the characteristics of DRPs in osteoporosis patients and evaluating the effect of CPCP in identifying and addressing DRPs. Methods We performed a prospective interventional study in a teaching hospital. CPCP was established and conducted to identify and resolve DRPs by a multidisciplinary team (MDT) based on the Pharmaceutical Care Network Europe (PCNE) classification V9.0. Six pharmacists and one doctor worked directly in the study. All data was obtained from electronic medical records, direct observation and visits. The statistical analyses were performed using the SPSS Statistics software version 26.0. Results Two hundred nineteen patients with osteoporosis were included in the final analysis. A total of 343 DRPs were identified, with an average of 1.57 DRPs per patient. The most common DRPs identified were “treatment safety P2” (66.8%; 229/343), followed by “other P3” (21.0%; 72/343) and “treatment effectiveness, P1” (12.2%; 42/343). The primary causes of DRPs were “dose selection C3” (35.9%; 211/588), followed by “drug use process C6” (28.9%; 170/588) and “drug selection C1” (12.6%; 74/588). Seven hundred eleven interventions were proposed to address the 343 DRPs, with an average of 2.1 interventions per DRP. The acceptance rate reached 95.9, and 91.0% of these accepted interventions were fully implemented. As a result, only 30 DRPs were unsolved before discharge. Additionally, the number of drugs was found to be associated with the number of DRPs significantly (p = 0.023). Conclusion DRPs frequently occurred in hospitalized osteoporosis patients. CPCP could be an effect option to solve and reduce DRPs for osteoporosis patients and should be implemented widely to increase patient safety.

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Section: Discussionmentioning

confidence: 99%

Application of comprehensive pharmaceutical care program in identifying and addressing drug-related problems in hospitalized patients with osteoporosis

Chen

Zhang

José

et al. 2022

BMC Health Serv Res

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“…Pharmacist-driven public health initiatives have demonstrated success in myriad settings. [25][26][27][28][29][30][31]…”

Section: Discussionmentioning

confidence: 99%

Comparing Hepatitis C Virus Screening in Clinics Versus the Emergency Department

Hluhanich

Ford

Bruce

et al. 2022

WestJEM

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Introduction: New evidence suggests that emergency department (ED)-based infectious diseases screening programs have utility. We aimed to compare clinic-based and ED-based hepatitis C virus (HCV) screening programs within a single health system, to identify key differences in HCV antibody (Ab) positivity and chronic HCV, as well as population demographics. Methods: In the clinic-based program, adults in the birth cohort (born 1945-1965) were screened for HCV. In the ED-based program, non-targeted HCV screening of all adults was conducted. We included patients screened between June 2019–June 2020. Patients were screened for anti-HCV Ab, and positive results were followed by HCV viral load (VL) testing. Our primary outcomes were seroprevalence of HCV Ab and HCV VL. Results: There were 1,296 and 12,778 patients screened for HCV in the clinics and the ED, respectively. In the clinic setting, 13 patients (1%) screened positive for HCV Ab and nine (69%) completed VL testing, which was positive in one patient (11%). In the ED, 1,053 patients (8%) screened positive for HCV Ab and 847 (80%) underwent reflex VL testing, which was positive in 381 patients (45%). In an ED birth cohort sub-analysis, Hepatitis C virus Ab seroprevalence was 15% (675/4521). Conclusion: In this study of patients in a single healthcare system, ED-based HCV screening was higher yield than clinic-based screening.

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“…Pharmacist-directed interventions for improving osteoporosis care have included screening for risk of osteoporosis and facilitating osteoporosis diagnosis using BMD testing, 25 as well as tailored counseling approaches focusing on medication adherence, lifestyle modifications, and mitigating osteoporosis risk factors. 26 These approaches have shown mixed results, with pharmacist screening for osteoporosis risk not improving the rate of osteoporosis diagnosis, while pharmacist-based medication counseling resulted in improved medication adherence at 6- and 12-month intervals.…”

Section: Discussionmentioning

confidence: 99%

“…Pharmacist-directed interventions. Pharmacistdirected interventions for improving osteoporosis care have included screening for risk of osteoporosis and facilitating osteoporosis diagnosis using BMD testing, 25 as well as tailored counseling An extensive pharmacist-directed medication management program using a unified medical record system was the Medication Monitoring and Optimization (MeMO) program, which was implemented in the Netherlands. 15 The MeMO program used a pharmacist information system to store the medication history of enrolled patients and included patient-centered pharmacist-delivered counseling and medication therapy management for several chronic illnesses, including osteoporosis.…”

Section: Healthcare System Interventionsmentioning

confidence: 99%

Improving drug adherence in osteoporosis: an update on more recent studies

Jaleel

Danila

2018

Therapeutic Advances in Musculoskeletal

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Similar to other chronic diseases such as diabetes and hypertension, osteoporosis has struggled with suboptimal medication adherence, resulting in an increased risk of fractures and all-cause mortality. The goal of this narrative review was to summarize interventions to improve medication adherence in osteoporosis. Because past reviews of this topic covered published literature through 2013, we conducted our literature search to include the period between January 2012 and November 2017. We identified 10 studies evaluating healthcare system and patient interventions aimed at improving osteoporosis treatment adherence, including three fracture liaison service (FLS) programs, one pharmacist-delivered counseling program, and six patient-directed interventions consisting of three coaching or counseling programs and three interventions using reminder prompts. Four out of the six patient-directed interventions did not lead to significant improvements in outcomes, suggesting that patient-directed interventions may have limited success in this setting. The healthcare system interventions that evaluated FLS programs and pharmacist-directed tailored counseling were effective at improving medication adherence; however, the studies were not randomized, they were costly, resource intensive and effective in countries with more centralized healthcare, possibly limiting their generalizability. In conclusion, while healthcare system interventions such as FLS, and pharmacist-delivered counseling appeared to be successful in improving osteoporosis medication adherence in some settings, behavioral interventions including patient counseling and reminder prompts for medication utilization were not, perhaps due to patient perceptions regarding osteoporosis consequences and need for treatment. Thus, these patient attributes may define patients 'at high risk' for poor adherence and developing intervention approaches to enhance patient knowledge and understanding of osteoporosis and its consequences may improve the perception of the need for treatment, optimize osteoporosis care and thereby improve overall outcomes of patients with osteoporosis. We hope that the knowledge gained through our review will help inform the design of further programs aimed at optimizing osteoporosis care.

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Pharmacist Screening for Risk of Osteoporosis in Elderly Veterans

Cited by 4 publications

References 0 publications

Application of comprehensive pharmaceutical care program in identifying and addressing drug-related problems in hospitalized patients with osteoporosis

Application of comprehensive pharmaceutical care program in identifying and addressing drug-related problems in hospitalized patients with osteoporosis

Comparing Hepatitis C Virus Screening in Clinics Versus the Emergency Department

Improving drug adherence in osteoporosis: an update on more recent studies

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