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Osteoporosis Prescribing in Long-Term Care: Impact of a Provincial Knowledge Translation Strategy*

Published online by Cambridge University Press:  08 April 2015

Courtney C. Kennedy ,
George Ioannidis ,
Lehana Thabane ,
Jonathan D. Adachi ,
Denis O’Donnell ,
Lora M. Giangregorio ,
Laura E. Pickard  and
Alexandra Papaioannou
Courtney C. Kennedy
Affiliation:
Department of Medicine, McMaster University St. Peter’s Hospital, GERAS Centre
George Ioannidis
Affiliation:
Department of Medicine, McMaster University St. Peter’s Hospital, GERAS Centre
Lehana Thabane
Affiliation:
Clinical Epidemiology and Biostatistics, McMaster University St Joseph’s Healthcare – Hamilton
Jonathan D. Adachi
Affiliation:
Department of Medicine, McMaster University St Joseph’s Healthcare – Hamilton Alliance for Better Bone Health Chair in Rheumatology
Denis O’Donnell
Affiliation:
Medical Pharmacies Group Limited
Lora M. Giangregorio
Affiliation:
Department of Kinesiology, University of Waterloo
Laura E. Pickard
Affiliation:
Department of Medicine, McMaster University St. Peter’s Hospital, GERAS Centre
Alexandra Papaioannou*
Affiliation:
Department of Medicine, McMaster University St. Peter’s Hospital, GERAS Centre Eli Lilly Canada Chair in Osteoporosis
*
†La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Alexandra Papaioannou, BScN, MD, MSc, FRCP (C), FACP McMaster University – Medicine Division of Geriatrics St. Peter’s Hospital 88 Maplewood Avenue GERAS Centre Hamilton, ON L8M 1W9 ([email protected])
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Abstract

This study described prescribing trends before and after implementing a provincial strategy aimed at improving osteoporosis and fracture prevention in Ontario long-term care (LTC) homes. Data were obtained from a pharmacy provider for 10 LTC homes in 2007 and 166 homes in 2012. We used weighted, multiple linear regression analyses to examine facility-level changes in vitamin D, calcium, and osteoporosis medication prescribing rates between 2007 and 2012. After five years, the estimated increase in vitamin D, calcium, and osteoporosis medication prescribing rates, respectively, was 38.2 per cent (95% confidence interval [CI]: 29.0, 47.3; p < .001), 4.0 per cent (95% CI: –3.9, 12.0; p = .318), and 0.2 per cent (95% CI: –3.3, 3.7; p = .91). Although the study could not assess causality, findings suggest that wide-scale knowledge translation activities successfully improved vitamin D prescribing rates, although ongoing efforts are needed to target homes with low uptake.

Résumé

Cette étude décrit les tendances de prescrire avant et après la mise en œuvre d'une stratégie provinciale visant à améliorer la prévention de l'ostéoporose et de la fracture dans les foyers de soins de longue durée (SLD) de l'Ontario. Les données ont été obtenues à partir d'une pharmacie qui a fourni pour 10 centres de SLD en 2007 et 166 foyers en 2012. Nos analyses ont utilisés la régression linéaire multiple et pondérée pour examiner les changements dans les niveaux ou les taux de prescriptions dans les établissements pour la vitamine D, le calcium et les médicaments pour l'ostéoporose de 2007 à 2012. Après cinq ans, l'augmentation des taux estimés pour la prescription de vitamine D, calcium et les médicaments pour l'ostéoporose, respectivement, était de 38,2 pour cent, 4 pour cent et 0,2 pour cent. Bien que l'étude n'a pas évalué la causalité, les résultats suggèrent que les activités à grande échelle dans le transfert des connaissances ont effectué des taux ameliorés de la prescription de vitamine D, bien que des efforts continus sont nécessaires pour cibler les foyers don’t les capacités de traduire les connaissances en pratique sont faibles.

Keywords

agingcalciumlong-term carenursing homeosteoporosisprescribingvitamin Dvieillissmentcalciumsoins de longue duréefoyers de soins infirmiersl'ostéoporose
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 34 , Issue 2 , June 2015 , pp. 137 - 148
Copyright
Copyright © Canadian Association on Gerontology 2015 

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Footnotes

*

We thank the Ministry of Health and Long-Term Care in Ontario for their support of the Ontario Osteoporosis Strategy.

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