4CPS-227 Management of osteoporosis in rheumatology day hospital: does the clinical pharmacist have a role to play?
Year: 2025
Type: conference-paper
Study design: Observational Study
Abstract: Background and Importance A multidisciplinary day hospitalisation (DH) dedicated to osteoporosis was established in our medical centre in May 2023. Clinical pharmacist provides individualised care through a medication review, a medication reconciliation and a pharmaceutical consultation (PC). Aim and Objectives The study aimed to assess the pharmaceutical impact in the management of patients with osteoporosis. Material and Methods All patients admitted to day hospital have a PC and the following points are discussed: information about disease and osteoporosis treatment and hygienic-dietary rules. Pharmaceutical interventions (PIs) are referred to the rheumatologist and general practitioners (GPs). Pharmaceutical reports are sent to GPs and community pharmacists. Data from patients who had a PC from May 2023 to May 2024 were extracted from the electronic medical record and pharmaceutical report and analysed. Results Over the study period, 78 patients (73% women) with a median age of 77 (51–97) years had a PC. Several drugs were presented to patients (mechanism of action, side effects, precautions for use): zoledronic acid (66.7%), teriparatide (12.8%), risedronate (11.5%), desonumab (6.4%), raloxifene (2.6%). Fall-increasing risk drugs were prescribed for 44.8% patients (benzodiazepine (10); antidepressant (10); opioid (8); alpha-blocker (8); hypnotic (7); diuretic (7); nonsteroidal anti-inflammatory drug (1)), and drug induced osteoporosis were prescribed for 61.5% patients (proton pump inhibitors (PPIs) (34); corticosteroids (13); chemotherapy (1)). In total, 63 PIs were performed (0.8 PI per patient): deprescription (opioid (9), benzodiazepine (8), PPIs (7)); dose adjustment (hypnotic (4), cholecalciferol (3), PPIs (1)); proposition to add a drug (calcium (15), cholecalciferol (10)); administration schedule adjustment (calcium (2)); galenic form (calcium (1)); optimisation of therapeutic strategy (antihypertensives (3)). Thirty-one PIs were performed to the rheumatologist and were accepted (100%), 32 IPs were performed to GPs. Smoking (10) and alcoholic patients (5) were offered a smoking and alcohol cessation programme. The 1 year hospitalisation rate for falls and fractures is 5.1%. Conclusion and Relevance This study highlights the positive impact of a clinical pharmacist intervention in an osteoporosis day hospital on therapeutic optimisation and patients education about their disease and treatments. All PIs referred to the rheumatologist were accepted. A study is undergoing to evaluate the acceptance rate of the PIs referred to GPs. References and/or Acknowledgements Conflict of Interest No conflict of interest
Authors: M Ayadi, M Megne-Wabo, D Chenevier, P Ranson, O Ighilahriz
Language: English
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4408376195