Urban–rural differences in the uptake of new oral bisphosphonate formulations

Jandoc, Racquel; Mamdani, Muhammad; Lévesque, Linda E.; Cadarette, Suzanne M.

doi:10.1007/s11657-016-0261-8

Cited by 3 publications

(2 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients were due for their next denosumab dose 6 mo (183 d) later, between January 2016 and December 2020. Restricting our baseline period to begin in 2016 avoided capturing potential irregularities in early uptake of denosumab 20 , 21 while satisfying modelling guidelines that recommend at least 50 pre-intervention timepoints. 22 The study period was restricted to the end of 2020 to capture the impact of the first wave of the pandemic without co-intervention from secondary lockdowns or COVID-19 vaccination in early 2021.…”

Section: Methodsmentioning

confidence: 99%

On-time denosumab dosing recovered rapidly during the COVID-19 pandemic, yet remains suboptimal

Rzepka,

Cheung,

Kim

et al. 2024

JBMR Plus

View full text Add to dashboard Cite

Timely administration of denosumab every 6 months is critical in osteoporosis treatment to avoid multiple vertebral fracture risk upon denosumab discontinuation or delay. This study aimed to estimate the immediate and prolonged impact of the COVID-19 pandemic on timing of denosumab doses. We identified older adults (≥ 66 years) residing in the community and due to receive denosumab between January 2016 and December 2020 using Ontario Drug Benefit data. We completed an interrupted time series analysis to estimate the impact of the COVID-19 pandemic (March 2020) on the monthly proportion of on-time denosumab doses (183 +/- 30 days). Analyses were stratified by user type: patients due for their 2nd dose (novice users), 3rd or 4th dose (intermediate users), or ≥ 5th dose (established users). In additional analyses, we considered patients living in nursing homes, switching to other osteoporosis drugs, and reported trends until February 2022. We studied 148 554 patients (90.9% female, mean [SD] age 79.6 [8.0] years) receiving 648 221 denosumab doses. The average pre-pandemic proportion of on-time therapy was steady in the community, yet differed by user type: 64.9% novice users, 72.3% intermediate users, and 78.0% established users. We identified an immediate overall decline in the proportion of on-time doses across all user types at the start of the pandemic: -17.8% (95% CI: -19.6, -16.0). In nursing homes, the pre-pandemic proportion of on-time therapy was similar across user types (average 83.5%), with a small decline at the start of the pandemic: -3.2% (95% CI: -5.0, -1.2). On-time therapy returned to pre-pandemic levels by October 2020 and was not impacted by therapy switching. Although on-time dosing remains stable as of February 2022, approximately one fourth of patients in the community do not receive denosumab on-time. In conclusion, although pandemic disruptions to denosumab dosing were temporary, levels of on-time therapy remain suboptimal.

show abstract

Section: Methodsmentioning

confidence: 99%

On-time denosumab dosing recovered rapidly during the COVID-19 pandemic, yet remains suboptimal

Rzepka,

Cheung,

Kim

et al. 2024

JBMR Plus

View full text Add to dashboard Cite

show abstract

“…geriatric medicine, neurology, psychiatry) or non-dementia related specialist, and location of practice (i.e. urban or rural[ 28 ]).…”

Section: Methodsmentioning

confidence: 99%

Comparison of prescribing practices for older adults treated by female versus male physicians: A retrospective cohort study

et al. 2018

View full text Add to dashboard Cite

ImportanceSubtle but important differences have been described in the way that male and female physicians care for their patients, with some evidence suggesting women are more likely to adhere to best practice recommendations.ObjectiveTo determine if male and female physicians differ in their prescribing practices as measured by the initiation of lower-than-recommended dose cholinesterase inhibitor (ChEI) drug therapy for dementia management.Design, setting, and participantsAll community-dwelling Ontario residents aged 66 years and older with dementia and newly dispensed an oral ChEI drug (donepezil, galantamine, or rivastigmine) between April 1, 2010 and June 30, 2016 were included.Main outcome and measuresThe association between physician sex and the initiation of a lower than recommended-dose ChEI was examined using generalized linear mixed regression models, adjusting for patient and physician characteristics. Data were stratified by specialty. Secondary analyses explored the association between physician sex and cardiac screening as well as shorter duration of the initial prescription.ResultsThe analysis included 3,443 female and 5,811 male physicians and the majority (83%) were family physicians, Female physicians were more likely to initiate ChEI therapy at a lower-than-recommended dose (Adjusted odds ratio = 1.43,95% confidence interval = 1.17 to 1.74). Compared to their male counterparts, female physicians were also more likely to follow other conservative prescribing practices including cardiac screening (55.1% vs. 49.2%, P-value<0.001) around the time of ChEI initiation, and dispensing a shorter duration of initial prescription (41.8% vs 35.5% P-value<0.001).ConclusionsThere is a statistically significant and important difference in ChEI prescribing patterns between female and male physicians, suggesting that female physicians may be more careful and conservative in their approaches. This will inform future research to determine if patients receiving lower-than-recommended initial doses also have better outcomes.

show abstract

Time trends in oral bisphosphonate initiation in Ontario, Canada over 20 years reflect drug policy and healthcare delivery changes

et al. 2019

View full text Add to dashboard Cite

Urban–rural differences in the uptake of new oral bisphosphonate formulations

Cited by 3 publications

References 26 publications

On-time denosumab dosing recovered rapidly during the COVID-19 pandemic, yet remains suboptimal

On-time denosumab dosing recovered rapidly during the COVID-19 pandemic, yet remains suboptimal

Comparison of prescribing practices for older adults treated by female versus male physicians: A retrospective cohort study

Time trends in oral bisphosphonate initiation in Ontario, Canada over 20 years reflect drug policy and healthcare delivery changes

Contact Info

Product

Resources

About