Pharmacists Improving Osteoporosis Management in Long-Term Care Using Fracture Risk Assessments: A Feasibility Study

IF 3.8 2区 医学 Q2 GERIATRICS & GERONTOLOGY Journal of the American Medical Directors Association Pub Date : 2025-04-01 Epub Date: 2025-02-26 DOI:10.1016/j.jamda.2025.105494
Catherine D. Laird BPharm, Kylie A. Williams BPharm, PhD, Helen Benson BPharm, PhD
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Abstract

Objectives

The primary outcome of this study is to test the feasibility of pharmacists completing Fracture Risk Scale (FRS) assessments using resident data routinely held by long-term care (LTC) facilities. Secondary outcomes are to ascertain the proportion of residents assessed as high fracture risk who currently receive osteoporosis medicines and explore whether under- or overuse of osteoporosis medicines is occurring based on residents' fracture risk.

Design

Feasibility study.

Setting and Participants

Four LTC facilities from southeast Queensland, Australia, with a total of 281 residents participated in the study during April and May 2024.

Methods

A pharmacist reviewed individual resident files for all residents of participating facilities. Necessary data were extracted from resident files to determine their fracture risk using the FRS manual calculation tool. Residents' use of osteoporosis medicines and nutritional supplements (vitamin D and calcium) was analyzed based on their calculated fracture risk.

Results

FRS assessments were completed for 275 residents (97.9%). There were 149 residents (54.2%) assessed as having a high fracture risk, of which 43 (28.9%) were prescribed an osteoporosis medicine. Conversely, 28 residents (22.2%) with a low fracture risk received an osteoporosis medicine. Underuse of vitamin D and calcium supplements was found for all residents, irrespective of fracture risk.

Conclusions and Implications

The feasibility of pharmacists completing FRS assessments was demonstrated. Incorporating the FRS into routine clinical practice provides a promising means to support pharmacists advising on osteoporosis prescribing decisions for LTC residents. Widespread underuse of vitamin D and calcium for all LTC residents and the underuse of osteoporosis medicines by residents with a high fracture risk were found. Future research is necessary to establish if incorporating the FRS into clinical practice can address this undertreatment and reduce fracture rates in LTC.
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药师通过骨折风险评估改善长期护理中骨质疏松管理的可行性研究。
目的:本研究的主要结果是测试药剂师完成骨折风险量表(FRS)评估的可行性,使用长期护理(LTC)机构常规持有的居民数据。次要结局是确定被评估为高骨折风险的居民目前服用骨质疏松药物的比例,并根据居民的骨折风险探讨骨质疏松药物是否发生过少或过度使用。设计:可行性研究。环境和参与者:来自澳大利亚昆士兰州东南部的四个LTC设施,共有281名居民参加了2024年4月至5月的研究。方法:由一名药剂师对所有参与机构的住院病人的个人档案进行审查。使用FRS人工计算工具从住院患者的档案中提取必要的数据,以确定他们的骨折风险。根据计算的骨折风险,分析居民使用骨质疏松药物和营养补充剂(维生素D和钙)的情况。结果:完成FRS评估275例(97.9%)。有149人(54.2%)被评估为骨折高危人群,其中43人(28.9%)服用了骨质疏松药物。相反,28名低骨折风险的居民(22.2%)接受了骨质疏松药物治疗。与骨折风险无关,所有居民都发现维生素D和钙补充剂的使用不足。结论与意义:验证了药师完成FRS评估的可行性。将FRS纳入常规临床实践提供了一种有希望的方法来支持药剂师为LTC居民提供骨质疏松症处方决策的建议。发现所有LTC居民普遍缺乏维生素D和钙的使用,以及高骨折风险居民缺乏骨质疏松症药物的使用。未来的研究需要确定将FRS纳入临床实践是否可以解决LTC治疗不足的问题并降低骨折发生率。
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来源期刊
CiteScore
11.10
自引率
6.60%
发文量
472
审稿时长
44 days
期刊介绍: JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates. The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality
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