title: [Deprescribing long-term treatments with bisphosphonates for osteoporosis in primary care in the Basque Country (Spain)].
abstract: OBJECTIVE
  To evaluate the impact of a multifactorial intervention to promote bisphosphonate deprescription after over 5 years of use (BF5y) in a health care organisation (HCO) in Gipuzkoa (Spain) and to compare it with the standard intervention in other HCOs in the Basque Health Service-Osakidetza.
  
  
  METHODS
  An 8-month follow-up study (results from before and after) to assess the impact of two interventions. All patients from Osakidetza receiving BF5y treatment (electronic prescription) in July 2013 were included. The standard intervention (9 HCOs) consisted of mailing a consensus statement on BF5y deprescribing and facilitating patient identifiers with BF5y prescription for review by the primary care physician. The multifactorial intervention (Gipuzkoa) also included a local consensus with leading specialists and training sessions in health centres.
  
  
  RESULTS
  18,725 patients were included; 94.7% were women. Standard intervention deprescribing rates ranged from 26.4% (Bilbao) to 49.4% (Araba), being 37.2% overall. The multifactorial intervention deprescribing rate was 44.6%, 7.4% (p <0.0001; 95% confidence interval [95%CI]: 5.4-9.4) higher than standard intervention. Changes to other treatments were less common with the multifactorial intervention, with a difference of 3.7% (p <0.0001; 95%CI: -2.2 to -5.2).
  
  
  CONCLUSIONS
  Standard and multifactorial interventions are very effective in reducing unnecessary treatments with bisphosphonates. The multifactorial intervention is more effective than the standard one, although more complex to implement.
authors: Farmacia de Atención Primaria, OSI Donostialdea, Hernani (Guipúzcoa), España. Electronic address: arritxuetxe@gmail.com.
authors: Arritxu
authors: A
authors: Etxeberria
authors: Farmacia de Atención Primaria, OSI Donostialdea, Hernani (Guipúzcoa), España.
authors: Josune
authors: J
authors: Iribar
authors: Centro de Salud de Tolosa, OSI Tolosaldea, Tolosa (Guipúzcoa), España.
authors: Javier
authors: J
authors: Hernando
authors: Centro de Salud de Tolosa, OSI Tolosaldea, Tolosa (Guipúzcoa), España.
authors: Ignacia
authors: I
authors: Idarreta
authors: Unidad de Investigación de Atención Primaria de Gipuzkoa, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), San Sebastián (Guipúzcoa), España.
authors: Itziar
authors: I
authors: Vergara
authors: Farmacia de Atención Primaria, OSI Tolosaldea, Hernani (Guipúzcoa), España.
authors: Carmela
authors: C
authors: Mozo
authors: Unidad de Investigación de Atención Primaria de Gipuzkoa, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), San Sebastián (Guipúzcoa), España.
authors: Kalliopi
authors: K
authors: Vrotsou
authors: Servicio de Reumatología, Hospital Universitario Donostia, OSI Donostialdea, San Sebastián (Guipúzcoa), España.
authors: Joaquín
authors: J
authors: Belzunegui
authors: Servicio de Ginecología, Hospital Universitario Donostia, OSI Donostialdea, San Sebastián (Guipúzcoa), España.
authors: Arantxa
authors: A
authors: Lekuona
mesh_terms: D000368:Aged; D000069340:Deprescriptions; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy*; D011320:Primary Health Care; D013030:Spain; D013997:Time Factors
chemical_list: D004164:Diphosphonates
keywords: Bisfosfonatos; Bisphosphonates; Deprescription; Desprescripción; Drug-related adverse reactions; Efectos adversos relacionados con fármacos; Implementación; Implementation; Inappropriate prescription; Osteoporosis; Prescripción inapropiada