Cerulli Jennifer, Roberts Alisha, Wilson Ellie, Guisinger Scott
Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, NY 12208, USA.
Northeast Shared Services, Schenectady, NY 12308, USA.
Pharmacy (Basel). 2025 Jul 23;13(4):100. doi: 10.3390/pharmacy13040100.
A total of 38% of Americans do not meet the Recommended Dietary Allowance (RDA) for calcium including those at risk for osteoporosis. To increase the percentage of patients at risk for osteoporosis who achieve goal calcium RDA intake, a collaborative specialty pharmacy-registered dietitian-nutritionist (RDN) quality improvement program was developed. Patients aged 18 to 90 years old receiving osteoporosis therapy (denosumab, teriparatide, zoledronic acid) or medications that increase bone loss (elagolix, oral prednisone) were provided with a structured assessment and educational intervention. Daily calcium intake included patient self-reported dietary intake plus supplement use. Written and verbal education on increasing dietary intake based on patient preferences was provided with 5 calcium-rich food-source store coupons. Recommendations for supplement selection (citrate vs. carbonate) and/or medication-related problem resolution were provided. Follow-up occurred at 3-6 months. Fifty patients enrolled [94% female, mean age 66.6 years (SD 15.3)] were taking denosumab (36), teriparatide (1), zoledronic acid (1), elagolix (7) and prednisone (5). The mean baseline daily dietary calcium intake was 500 mg (SD 247) with none achieving goal intake with diet alone. Average calcium supplement use in 22 (44%) patients was 686 mg daily (SD 284). At baseline, 17 (34%) met goal daily calcium intake compared to 30 (60%) at post intervention follow-up ( = 0.009). Over half of the store coupons were redeemed. A specialty pharmacy-RDN customized intervention program provides a model for aiding patients to modify calcium intake.
共有38%的美国人未达到钙的推荐膳食摄入量（RDA），包括那些有骨质疏松症风险的人。为了提高有骨质疏松症风险的患者实现钙RDA目标摄入量的比例，开展了一项由专科药房注册营养师（RDN）合作的质量改进项目。为年龄在18至90岁、接受骨质疏松症治疗（地诺单抗、特立帕肽、唑来膦酸）或增加骨质流失药物（艾拉戈利克斯、口服泼尼松）治疗的患者提供结构化评估和教育干预。每日钙摄入量包括患者自我报告的饮食摄入量加上补充剂的使用情况。根据患者偏好提供关于增加饮食摄入量的书面和口头教育，并提供5张富含钙的食物来源商店优惠券。提供补充剂选择（柠檬酸盐与碳酸盐）的建议和/或解决与药物相关的问题。在3至6个月时进行随访。入组的50名患者[94%为女性，平均年龄66.6岁（标准差15.3）]正在服用地诺单抗（36人）、特立帕肽（1人）、唑来膦酸（1人）、艾拉戈利克斯（7人）和泼尼松（5人）。平均基线每日饮食钙摄入量为500毫克（标准差247），没有患者仅通过饮食达到目标摄入量。22名（44%）患者的平均钙补充剂使用量为每日686毫克（标准差284）。基线时，17名（34%）患者达到每日钙目标摄入量，干预后随访时这一比例为30名（60%）（P = 0.009）。超过一半的商店优惠券被兑换。专科药房 - RDN定制的干预项目为帮助患者改变钙摄入量提供了一个模式。
