Heyman Noemi, Etzion Isaac, Ben Natan Merav
Department of Geriatrics, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Shoham Medical Center, Pardes Hanna, Israel.
Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel.
Osteoporos Sarcopenia. 2018 Dec;4(4):134-139. doi: 10.1016/j.afos.2018.11.084. Epub 2018 Nov 30.
The aim of this study was to examine whether coordination between healthcare providers at an inpatient rehabilitation facility and healthcare providers in a community setting improves osteoporosis medication use in the community.
In 2012, a coordination project between an inpatient geriatric rehabilitation facility located in north-central Israel and general practitioners in the community setting was initiated. In this retrospective pseudo-experimental study, we compared osteoporosis medication use among patients who were hospitalized at the facility following an osteoporotic fracture during 2011-2012, and who constituted the control group (n=120), and patients who were hospitalized at the facility during 2013-2015, and who constituted the trial group (n=129). Data were collected from the patients' records and from records of the health maintenance organization concerning medications issued to the patients by pharmacies.
Differences were observed between the trial and the control group in osteoporosis medication management by healthcare providers, both at the inpatient rehabilitation facility and in the community, suggesting favorable trends. However, osteoporosis medication use in the community was slightly lower in the trial group, then in the control group (32.8% vs. 34.2%, respectively). A regression analysis indicated that the only variable predicting use of osteoporosis medications in the community was a previous diagnosis of osteoporosis in the community.
The study results indicate that mere coordination between the healthcare settings is insufficient in order to ensure continued care in the community, emphasizing the need for an osteoporosis coordinator.
本研究旨在探讨住院康复机构的医疗服务提供者与社区医疗服务提供者之间的协调是否能改善社区骨质疏松症药物的使用情况。
2012年，以色列中北部一家老年住院康复机构与社区全科医生启动了一项协调项目。在这项回顾性准实验研究中，我们比较了2011 - 2012年因骨质疏松性骨折在该机构住院的患者（构成对照组，n = 120）和2013 - 2015年在该机构住院的患者（构成试验组，n = 129）的骨质疏松症药物使用情况。数据从患者记录以及健康维护组织关于药房向患者发放药物的记录中收集。
在住院康复机构和社区，医疗服务提供者在骨质疏松症药物管理方面，试验组与对照组之间存在差异，显示出有利趋势。然而，试验组社区骨质疏松症药物的使用略低于对照组（分别为32.8%和34.2%）。回归分析表明，预测社区骨质疏松症药物使用的唯一变量是社区先前的骨质疏松症诊断。
研究结果表明，仅仅医疗环境之间的协调不足以确保社区的持续护理，强调了需要一名骨质疏松症协调员。
