Kennedy Courtney C, Ioannidis George, Thabane Lehana, Adachi Jonathan D, O'Donnell Denis, Giangregorio Lora M, Pickard Laura E, Papaioannou Alexandra
Department of Medicine,McMaster University.
Clinical Epidemiology and Biostatistics,McMaster University.
Can J Aging. 2015 Jun;34(2):137-48. doi: 10.1017/S0714980815000057. Epub 2015 Apr 8.
This study described prescribing trends before and after implementing a provincial strategy aimed at improving osteoporosis and fracture prevention in Ontario long-term care (LTC) homes. Data were obtained from a pharmacy provider for 10 LTC homes in 2007 and 166 homes in 2012. We used weighted, multiple linear regression analyses to examine facility-level changes in vitamin D, calcium, and osteoporosis medication prescribing rates between 2007 and 2012. After five years, the estimated increase in vitamin D, calcium, and osteoporosis medication prescribing rates, respectively, was 38.2 per cent (95% confidence interval [CI]: 29.0, 47.3; p < .001), 4.0 per cent (95% CI: -3.9, 12.0; p = .318), and 0.2 per cent (95% CI: -3.3, 3.7; p = .91). Although the study could not assess causality, findings suggest that wide-scale knowledge translation activities successfully improved vitamin D prescribing rates, although ongoing efforts are needed to target homes with low uptake.
本研究描述了安大略省长期护理(LTC)机构实施一项旨在改善骨质疏松症及骨折预防的省级策略前后的处方趋势。数据于2007年从一家药房供应商处获取,涉及10家LTC机构,2012年涉及166家机构。我们采用加权多元线性回归分析,以研究2007年至2012年期间维生素D、钙和骨质疏松症药物处方率在机构层面的变化。五年后,维生素D、钙和骨质疏松症药物处方率的估计增幅分别为38.2%(95%置信区间[CI]:29.0,47.3;p <.001)、4.0%(95%CI:-3.9,12.0;p = 0.318)和0.2%(95%CI:-3.3,3.7;p = 0.91)。尽管该研究无法评估因果关系,但研究结果表明,大规模的知识转化活动成功提高了维生素D的处方率,不过仍需持续努力,以针对那些使用率较低的机构。