Royal College of Surgeons, Dublin, Ireland.
Bone Health Unit, St James's Hospital, Dublin, Ireland.
Ir J Med Sci. 2024 Feb;193(1):271-276. doi: 10.1007/s11845-023-03383-w. Epub 2023 May 22.
Denosumab is commonly used by general practitioners (GPs) in Ireland to treat osteoporosis though drug holidays are not recommended with rebound bone loss and risk of vertebral fractures if stopped. We aimed to investigate GP practice and knowledge regarding denosumab including use and reasons for use, therapy duration, blood monitoring and recommended vitamin D status/calcium intake on treatment, staff administering, methods of recall, delays in receiving injections, management of and awarenes of guidelines if stopped, reasons for stopping and concerns about same.
GPs were contacted (n = 846) by email and invited to complete an online anonymous survey comprising 25 questions in January 2022. We collated responses and explored for differences between GP principals/trainers and GP trainees.
There were 146 responses. Sixty-seven percent were female and 50% were GP principal/trainers. Forty-three percent used denosumab as a first line therapy citing convenience in 32% of cases. Half (50%) envisaged therapy for 3-5 years and 15% lifelong use. A fifth (21%) had no concerns about it being stopped (11% trainors vs 31% trainees, P = 0.002). If stopped, 41% cited opting for a drug holiday with monitoring. Forty percent of GPs gave patients a reminder card for the next injection and 27% had an alert system.
We identified a knowledge gap in denosumab prescribing among a sample of Irish GPs. Findings suggest a need for education to increase awareness around denosumab use and to consider recall systems in GP practices as suggested elsewhere to ensure persistence with therapy.
尽管不建议使用药物假期，因为停药会导致骨丢失反弹和椎体骨折风险增加，但在爱尔兰，全科医生（GP）通常会使用地舒单抗治疗骨质疏松症。我们旨在调查全科医生对地舒单抗的实践和知识，包括使用和使用原因、治疗持续时间、血液监测以及治疗期间推荐的维生素 D 状态/钙摄入量、给药人员、召回方法、延迟注射、如果停药的管理和对指南的认识、停药原因和对停药的担忧。
我们通过电子邮件联系了全科医生（n=846），邀请他们在 2022 年 1 月完成一份包含 25 个问题的在线匿名调查。我们整理了回复并探讨了全科医生主任/培训师和全科医生培训生之间的差异。
共收到 146 份回复。67%为女性，50%为全科医生主任/培训师。43%将地舒单抗作为一线治疗药物，其中 32%的病例认为其方便。一半（50%）预计治疗时间为 3-5 年，15%为终身使用。五分之一（21%）对地舒单抗停药没有顾虑（11%的培训师与 31%的培训生相比，P=0.002）。如果停药，41%的人会选择在监测下进行药物假期。40%的全科医生会给患者下一次注射的提醒卡，27%的人有提醒系统。
我们在爱尔兰全科医生样本中发现了地舒单抗处方方面的知识差距。研究结果表明，需要进行教育，以提高对地舒单抗使用的认识，并考虑在全科医生实践中引入召回系统，以确保治疗的持续性，这与其他地方的建议一致。
