| Title | What triggers osteoporosis therapy in high risk residents living in long term care (LTC) homes? The gaining optimal osteoporosis assessments in long-term care (GOAL) study |
| Publication Type | Conference Paper |
| Year of Publication | 2015 |
| Authors | Ioannidis G., O'Donnell D., Kennedy C., Navare H., Giangregorio L.M, Cheung A.M, Marr S., Crilly R.G, Feldman S., Jain R., Jamal S., Josse R.G, Prasad S., Thabane L., Adachi J.D, Papaioannou A. |
| Conference Name | Osteoporosis International |
| Issue | 1 SUPPL. 1 |
| Keywords | *long term care, *musculoskeletal disease, *osteoarthritis, *osteoporosis, *Risk, *therapy, Canada, corticosteroid, data base, Diagnosis, Drug Therapy, fracture, hip, hip fracture, Human, Medical Audit, pharmacy, prednisone, randomized controlled trial, sample size, spine fracture, vitamin D |
| Abstract | Objective: The GOAL initiative was developed to assess high risk residents and recommend appropriate pharmacotherapy to reduce fractures by utilizing multifaceted knowledge translation strategies. These strategies were directed at the inter-professional team in the LTC homes. Method(s): GOAL is a delayed entry stepped wedge cluster randomized controlled trial in 50 LTC homes in Ontario. De-identified clinical/prescribing data were downloaded from the database of a large pharmacy provider that services all study homes. Chart audits were performed and the Resident Assessment Instrument Minimum Data Set (RAI-MDS) data were examined to determine the number of high risk residents for fracture. In this baseline analysis, we calculated the proportion of high-risk residents who were receiving osteoporosis medications and vitamin D (>=800 mg/d), according to specific high risk categories. Based on osteoporosis guidelines, high-risk was identified as individuals who had at least one spine/ hip fracture, 2 or more non-hip/non-spine fractures, or were currently taking corticosteroids (>7.5 mg/d prednisone equivalent). Residents who had a previous diagnosis of osteoporosis were also considered at high risk. Result(s): Of the 6862 residents from 50 LTC homes who were evaluated, a total of 2949 (43.0 %) were considered at high risk. High risk residents had a mean age (SD) of 85.9 (9.0) years, weighed 64 (17.1) kg and were 158.5(10) cm tall. Osteoporosis medications were taken by 47 % (151/320), 34 % (294/874), 38 % (51/136), 43 % (58/134) and 41 % (976/2395) of residents who had a prior spine fracture, hip fracture, two or more non-hip or non-spine fractures, were taking corticosteroids, or had a diagnosis of osteoporosis, respectively. In addition, 77 % (2255/2949) of high risk residents were on vitamin D therapy. Conclusion(s): Residents with prior spine fractures had the highest and those with prior hip fractures had the lowest percentages of receiving osteoporosis medications. Our findings suggest a potential osteoporosis treatment gap that may be reduced though knowledge translation strategies. |
| DOI | 10.1007/s00198-015-3067-4 |
| Reseach Notes | AM |
