An evaluation of managing and educating patients on the risk of glucocorticoid-induced osteoporosis.
OBJECTIVE
To assess the impact of risk management activities on patient risk of glucocorticoid-induced osteoporosis.


METHODS
Ninety-six adult patients taking chronic glucocorticoid therapy in 15 community pharmacies. Patients in the control group received usual and customary care. Patients in the treatment pharmacies received education and an educational pamphlet about the risks of glucocorticoid-induced osteoporosis. In addition, the treatment group pharmacists monitored the patients' drug therapy, to identify and address drug-related problems. Data including the glucocorticoid taken by the patient, medications, and osteoporosis risk factors were collected at baseline and after 9 months of monitoring, via Web-based survey completed in the pharmacy. Using an intent to treat approach, the pre-post frequency changes were compared with contrasts for presence of bisphosphonate therapy, presence of estrogen therapy, presence of calcium supplement, discussion of glucocorticoid-induced osteoporosis risk, discussion of bone density test, presence of bone mineral density test, reported inactivity, and reported low calcium diet.


RESULTS
The contrast was significant in favor of the treatment pharmacies for the frequency of patients taking a calcium supplement (Control [-6.9%] vs. Treatment [17.1%], P < 0.05). No other contrast was significant.


CONCLUSIONS
Community pharmacists are capable of increasing calcium supplementation among patients at risk for glucocorticoid-induced osteoporosis. Pharmacists who educate at-risk patients can impact the self-care of these patients.
McDonough
Randy P
RP
The University of Iowa, College of Pharmacy, Iowa City, IA 52242, USA.
Doucette
William R
WR
Kumbera
Patty
P
Klepser
Donald G
DG
D000328:Adult; D015519:Bone Density; D002118:Calcium / Q000627:therapeutic use; D002136:Calcium, Dietary / Q000008:administration & dosage; D004164:Diphosphonates / Q000627:therapeutic use; D016903:Drug Monitoring / Q000379:methods / Q000592:standards; D004513:Education, Pharmacy, Continuing / Q000458:organization & administration; D015914:Estrogen Replacement Therapy; D015444:Exercise; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007484:Iowa; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control*; D010174:Pamphlets; D010353:Patient Education as Topic / Q000458:organization & administration*; D010594:Pharmacies / Q000458:organization & administration*; D011241:Prednisone / Q000009:adverse effects*; D015397:Program Evaluation; D012307:Risk Factors; D012648:Self Care
D002136:Calcium, Dietary; D004164:Diphosphonates; D005938:Glucocorticoids; D002118:Calcium; D011241:Prednisone