Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
Institute of Health Policy, Management & Evaluation, University of Toronto, 4th Floor - 155 College Street, Toronto, ON, M5T 3M6, Canada.
Osteoporos Int. 2022 Nov;33(11):2435-2440. doi: 10.1007/s00198-022-06446-3. Epub 2022 Jun 28.
In an Ontario fracture liaison service (FLS), we compared medication prescription rates among patients not taking a previously prescribed bone active medication to those with no previous prescription. Prescription rates were similar between these two groups of patients. The FLS provided a secondary opportunity for patients to initiate bone active medication.
We compared bone active medication prescription rates among patients presenting to an Ontario fracture liaison service (FLS) who reported not taking a previously prescribed bone active medication to those with no history of prescription.
Eligible patients were those screened in 39 fracture clinics between July 1, 2017, and September 15, 2019, who were not taking bone active medication at the time of screening and classified as high risk for future fracture based on CAROC or FRAX. Sociodemographic and clinical risk factor variables were assessed at screening. Bone active medication prescription rate was assessed within 6 months of screening and defined as having received a prescription for the medication from either a specialist or primary care provider. In cases where a specialist report was not available, patient self-reported data were collected. The chi-square test of independence was used to assess differences in prescription rates.
Of 17,575 patients screened, eligible patients were 350 with a previous prescription and 2644 without a previous prescription. Compared with patients who reported no previous prescription, those who had a previous prescription were older, more likely to be female and to report a previous fracture, and less likely to smoke. There was no statistically significant difference between the medication prescription rate of patients with a previous prescription (73.7%) compared to patients with no previous prescription (70.7%) (p = 0.157).
A large jurisdiction-wide FLS approach provided a secondary opportunity to patients who were not taking a previously prescribed bone active medication to initiate that medication.
未服用既往处方骨活性药物患者与无既往处方患者相比，在安大略省骨折联络服务（FLS）中，我们比较了药物处方率。这两组患者的处方率相似。FLS 为患者提供了开始使用骨活性药物的第二次机会。
我们比较了在安大略省骨折联络服务（FLS）就诊的报告未服用既往处方骨活性药物的患者与无既往处方患者之间的骨活性药物处方率。
符合条件的患者是在 2017 年 7 月 1 日至 2019 年 9 月 15 日期间在 39 个骨折诊所接受筛查的患者，在筛查时未服用骨活性药物，并且根据 CAROC 或 FRAX 被归类为未来骨折的高风险。在筛查时评估社会人口统计学和临床危险因素变量。在筛查后 6 个月内评估骨活性药物处方率，并定义为从专家或初级保健提供者处获得药物处方。在无法获得专家报告的情况下，收集患者的自我报告数据。使用独立性卡方检验评估处方率的差异。
在接受筛查的 17575 名患者中，符合条件的患者为 350 名有既往处方，2644 名无既往处方。与报告无既往处方的患者相比，有既往处方的患者年龄更大，更可能是女性且报告有既往骨折，并且吸烟的可能性更小。有既往处方的患者（73.7%）与无既往处方的患者（70.7%）的药物处方率之间无统计学显著差异（p=0.157）。
在一个大型的、以司法管辖区为基础的 FLS 方法中，为未服用既往处方骨活性药物的患者提供了开始使用该药物的第二次机会。
