62–5.05) 1.74 (0.61–4.99) Stratified by age categoryb ≤70 years 13.5 12.5 1.10 (0.61–1.98) 1.16 (0.64–2.09) >70 years 13.4 6.5 2.14 (1.07–4.30) 2.22 (1.11–4.47) OP osteoporosis prophylaxis drugs, HR hazard ratio, CI confidence interval, DDDs defined daily dosage prednisone equivalents aAdjusted for age categories (≤70, >70) and use of hydrocortisone in the 6 months before baseline bAdjusted for hydrocortisone use in
the 6 months before baseline Discussion This randomised controlled trial showed that active identification of GIOP-eligible patients by community pharmacists did not significantly increase the prescribing rate of bisphosphonates in the total study population. However, subgroup analyses showed that there was a significant increase in the primary endpoint in males and in the elderly (>70 years). Similar results
were seen for the composite endpoint of any prophylactic osteoporosis drug (bisphosphonate, calcium, or DMXAA mouse vitamin D). To the best of our knowledge, this is the first randomised controlled trial where pharmacists identified GIOP-eligible patients and subsequently contacted the prescriber, without further training of the patient or the physician [22]. The only previously conducted pharmacy-based randomised controlled trial that aimed to increase GIOP found an increased prescribing Selleckchem Trichostatin A rate of calcium but not of bisphosphonates [19]. This trial was conducted at 15 community pharmacies (intervention 70 patients, control 26 patients). The pharmacists received training for GIOP, identified eligible patients, gave them education for GIOP and contacted the prescriber when necessary. However, pharmacists in both the intervention and control groups received training about GIOP and the importance of bone mineral density (BMD) testing which may have diluted the results. GABA Receptor Another randomised controlled trial has shown a twofold increase (28 patients (22 %) intervention group vs. 14 patients (11 %) control group; relative risk 2.1, 95 % CI 1.1–3.7) in the composite endpoint of BMD testing or incident osteoporosis treatment with a community pharmacist screening programme [21]. In contrast to the present study, all patients and pharmacists received education about osteoporosis.
Other attempts to increase GIOP mostly included educational interventions directed at physicians (general practitioners or rheumatologists) but were often without or with modest results [16–18]. The lack of an overall intervention effect was accompanied by a low number of bisphosphonate-treated patients [14, 17]. It should be noted that the study population did not include patients who already received a prescription for a bisphosphonate in the 6 months prior to baseline. Chitre et al. (2008) similarly excluded these patients and found comparable incident treatment rates for osteoporosis prophylaxis. In addition, our study population included patients who received a bisphosphonate more than 6 months before baseline (10.8 % in the intervention group, 12.
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