Ishihara Nonoko, Yamashita Shuji, Seiki Shizuno, Tsutsui Keito, Kato-Hayashi Hiroko, Sakurai Shuji, Niwa Kyoko, Kawai Takuyoshi, Kai Junko, Suzuki Akio, Hayashi Hideki
Laboratory of Home Team Care Pharmacy, Gifu Pharmaceutical University, 1-25-4 Daigaku Nishi, Gifu 501-1196, Gifu, Japan.
Laboratory of Community Pharmaceutical Practice and Science, Gifu Pharmaceutical University, 1-25-4 Daigaku Nishi, Gifu 501-1196, Gifu, Japan.
Pharmacy (Basel). 2024 May 15;12(3):80. doi: 10.3390/pharmacy12030080.
Glucocorticoid-induced osteoporosis (GIOP) is a side effect of glucocorticoid (GC) treatment; however, despite established prevention guidelines in various countries, a gap persists between these guidelines and clinical practice. To address this gap, we implemented a collaborative intervention between hospitals and community pharmacists, aiming to assess its effectiveness. Pharmacists recommended to the prescribing doctor osteoporosis treatment for patients who did not undergo osteoporosis treatment with a fracture risk score of ≥3 via tracing reports (TRs), between 15 December 2021, and 21 January 2022. Data were extracted from electronic medical records, including prescriptions, concomitant medications, reasons for not pursuing osteoporosis treatment, and TR contents. Of 391 evaluated patients, 45 were eligible for TRs, with 34 (75.6%) being males. Prednisolone was the most common GCs administered, and urology was the predominant treatment department. Among the 45 patients who received TRs, prescription suggestions were accepted for 19 (42.2%). After undertaking the intervention, guideline adherence significantly increased from 87% to 92.5%. This improvement indicates that TRs effectively bridged the evidence-practice gap in GIOP prevention among GC patients, suggesting their potential utility. Expansion of this initiative is warranted to further prevent GIOP.
糖皮质激素诱导的骨质疏松症（GIOP）是糖皮质激素（GC）治疗的一种副作用；然而，尽管各国都制定了预防指南，但这些指南与临床实践之间仍存在差距。为了弥补这一差距，我们实施了一项医院与社区药剂师之间的合作干预措施，旨在评估其有效性。在2021年12月15日至2022年1月21日期间，药剂师通过追踪报告（TR），向未接受骨质疏松症治疗且骨折风险评分≥3的患者的开处方医生推荐骨质疏松症治疗。数据从电子病历中提取，包括处方、伴随用药、未进行骨质疏松症治疗的原因以及TR内容。在391名评估患者中，45名符合TR条件，其中34名（75.6%）为男性。泼尼松龙是最常用的GC，泌尿外科是主要治疗科室。在接受TR的45名患者中，19名（42.2%）接受了处方建议。干预后，指南依从性从87%显著提高到92.5%。这一改善表明，TR有效地弥合了GC患者GIOP预防中证据与实践之间的差距，表明了它们的潜在效用。有必要扩大这一举措，以进一步预防GIOP。
