International Journal of Clinical Pharmacy

, Volume 35, Issue 4, pp 629–637 | Cite as

Impact of pharmaceutical care on knowledge, quality of life and satisfaction of postmenopausal women with osteoporosis

  • Pauline Siew Mei Lai
  • Siew Siang Chua
  • Siew Pheng Chan
Research Article

Abstract

Background This study describes the analysis of secondary outcomes from a previously published randomised controlled trial, which assessed the effects of pharmaceutical care on medication adherence, persistence and bone turnover markers. The main focus of this manuscript is the effect of the provision of pharmaceutical care on these secondary outcomes, and details on the design of the intervention provided, the osteoporosis care plan and materials used to deliver the intervention. Objectives To evaluate the effects of pharmaceutical care on knowledge, quality of life (QOL) and satisfaction of postmenopausal osteoporotic women prescribed bisphosphonates, and their associating factors. Setting Randomised controlled trial, performed at an osteoporosis clinic of a tertiary hospital in Malaysia. Methods Postmenopausal women diagnosed with osteoporosis (T-score ≤−2.5/lowtrauma fracture), just been prescribed weekly alendronate/risedronate were randomly allocated to receive intervention or standard care (controls). Intervention participants received a medication review, education on osteoporosis, risk factors, lifestyle modifications, goals of therapy, side effects and the importance of medication adherence at months 0, 3, 6 and 12. Main outcomes measure Knowledge, QOL and satisfaction. Results A total of 198 postmenopausal osteoporotic women were recruited: intervention = 100 and control = 98. Intervention participants reported significantly higher knowledge scores at months 3 (72.50 vs. 62.50 %), 6 (75.00 vs. 65.00 %) and 12 (78.75 vs. 68.75 %) compared to control participants. QOL scores were also lower (which indicates better QOL) at months 3 (29.33 vs. 38.41), 6 (27.50 vs. 36.56) and 12 (27.53 vs. 37.56) compared to control participants. Similarly, satisfaction score was higher in intervention participants (93.67 vs. 84.83 %). More educated women, with back pain, who were provided pharmaceutical care had better knowledge levels. Similarly, older, more educated women, with previous falls and back pain tend to have poorer QOL, whilst women who exercised more frequently and were provided pharmaceutical care had better QOL. Satisfaction also increased as QOL increases and when provided pharmaceutical care. Conclusion The provision of pharmaceutical care improved knowledge, QOL and satisfaction in Malaysian postmenopausal osteoporotic women, showing that pharmacists have the potential to improve patients’ overall bone health. Policymakers should consider placing a clinical pharmacist in the osteoporosis clinic to provide counselling to improve these outcomes.

Keywords

Knowledge Malaysia Osteoporosis Patient satisfaction Pharmaceutical care Quality of life 

Notes

Acknowledgments

We would like to thank Professor Ian Chi Kei Wong (Centre for Paediatric Pharmacy Research, School of Pharmacy, University of London) for his feedback on the questionnaire. We also like to extend our appreciation to Dr. David Wu, Statistician (Monash University, Sunway campus, Malaysia) for his advice on statistical procedures. Last but not least, we would like to thank all the research participants for their involvement in this study.

Funding

This project was funded by the Postgraduate Research Fund P0110/2006B, University of Malaya and the Endocrine Research fund, University of Malaya.

Conflicts of interest

None.

Supplementary material

11096_2013_9784_MOESM1_ESM.pdf (207 kb)
Supplementary material 1 (PDF 207 kb)

References

  1. 1.
    Cooper C, Campion G, Melton LJ 3rd. Hip fractures in the elderly: a world-wide projection. Osteoporos Int. 1992;2(6):285–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Kao PC, P’eng FK. How to reduce the risk factors of osteoporosis in Asia. Chung-Hua I Hsueh Tsa Chih (Chinese Medical Journal) (Taipei). 1995;55(3):209–13.Google Scholar
  3. 3.
    Burge R, Dawson-Hughes B, Solomon DH. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res. 2007;22:465–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Rolnick SJ, Kopher R, Jackson J, Fischer LR, Compo R. What is the impact of osteoporosis education and bone mineral density testing for postmenopausal women in a managed care setting. Menopause. 2001;8(2):141–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Lai P, Chua SS, Chan SP. A systematic review of interventions by healthcare professionals on community-dwelling postmenopausal women with osteoporosis. Osteoporos Int. 2010;21(10):1637–56.PubMedCrossRefGoogle Scholar
  6. 6.
    Cranney A, Lam M, Ruhland L, Brison R, Godwin M, Harrison MM, et al. A multifaceted intervention to improve treatment of osteoporosis in postmenopausal women with wrist fractures: a cluster randomized trial. Osteoporos Int. 2008;19(12):1733–40.PubMedCrossRefGoogle Scholar
  7. 7.
    Nielsen D, Ryg J, Nissen N, Nielsen W, Knold B, Brixen K. Multidisciplinary patient education in groups increases knowledge on osteoporosis: a randomized controlled trial. Scand J Public Health. 2008;36(4):346–52.PubMedCrossRefGoogle Scholar
  8. 8.
    Estok PJ, Sedlak CA, Doheny MO, Hall R. Structural model for osteoporosis preventing behavior in postmenopausal women. Nurs Res. 2007;56(3):148–58.PubMedCrossRefGoogle Scholar
  9. 9.
    Majumdar SR, Johnson JA, McAlister FA, Bellerose D, Rowe BH. Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture: a randomized controlled trial. CMAJ. 2008;178(5):569–75.PubMedGoogle Scholar
  10. 10.
    Sedlak CA, Doheny MO, Estok PJ, Zeller RA. Tailored interventions to enhance osteoporosis prevention in women. Orthop Nurs. 2005;24(4):270–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Binder EF, Brown M, Sinacore DR, Steger-May K, Yarasheski KE, Schechtman KB. Effects of extended outpatient rehabilitation after hip fracture: a randomized controlled trial. JAMA. 2004;292(7):837–46.PubMedCrossRefGoogle Scholar
  12. 12.
    Papaioannou A, Adachi JD, Winegard K, Ferko N, Parkinson W, Cook RJ, et al. Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures. Osteoporos Int. 2003;14(8):677–82.PubMedCrossRefGoogle Scholar
  13. 13.
    Bravo G, Gauthier P, Roy PM, Payette H, Gaulin P, Harvey M, et al. Impact of a 12-month exercise program on the physical and psychological health of osteopenic women. J Am Geriatr Soc. 1996;44(7):756–62.PubMedGoogle Scholar
  14. 14.
    Malmros B, Mortenson L, Jensen MB, Charles P. Positive effects of physiotherapy on chronic pain and performance in osteoporosis. Osteoporos Int. 1998;8:215–21.PubMedCrossRefGoogle Scholar
  15. 15.
    Alp A, Kanat E, Yurtkuran M. Efficacy of a self-management program for osteoporotic subjects. Am J Phys Med Rehabil. 2007;86(8):633–40.PubMedCrossRefGoogle Scholar
  16. 16.
    Guilera M, Fuentes M, Grifols M, Ferrer J, Badia X. Does an educational leaflet improve self-reported adherence to therapy in osteoporosis? The OPTIMA study. Osteoporos Int. 2006;17(5):664–71.PubMedCrossRefGoogle Scholar
  17. 17.
    Hongo M, Itoi E, Sinaki M, Miyakoshi N, Shimada Y, Maekawa S, et al. Effect of low-intensity back exercise on quality of life and back extensor strength in patients with osteoporosis: a randomized controlled trial. Osteoporos Int. 2007;18(10):1389–95.PubMedCrossRefGoogle Scholar
  18. 18.
    Tsauo JY, Leu WS, Chen YT, Yang RS. Effects on function and quality of life of postoperative home-based physical therapy for patients with hip fracture. Arch Phys Med Rehabil. 2005;86(10):1953–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Majumdar SR, Beaupre LA, Harley CH, Hanley DA, Morrish DW. Use of a case manager to improve osteoporosis treatment after hip fracture—results of a randomized controlled trial. Arch Int Med. 2007;167(19):2110–5.CrossRefGoogle Scholar
  20. 20.
    van Haastregt JCM, Diederiks JPM, van Rossum E, de Witte LP, Voorhoeve PM, Crebolder HF. Effects of a programme of multifactorial home visits on falls and mobility impairments in elderly people at risk: a randomized controlled trial. BMJ. 2000;321:994–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Elley CR, Robertson MC, Garrett S, Kerse NM, McKinlay E, Lawton B, et al. Effectiveness of falls-and-fracture nurse coordinator to reduce falls: a randomized, controlled trial of at-risk older adults. J Am Geriatr Soc. 2008;56(8):1383–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Carter ND, Khan KM, McKay HA, Petit MA, Waterman C, Heinonen A, et al. Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: a randomized controlled trial. CMAJ. 2002;167(9):997–1004.PubMedGoogle Scholar
  23. 23.
    Delmas PD, Vrijens B, Eastell R, Roux C, Pols HAP, Ringe JD, et al. Effect of monitoring bone turnover markers on persistence with risedronate treatment of postmenopausal osteoporosis. J Clin Endrocrinol Metab. 2007;92(4):1296–304.CrossRefGoogle Scholar
  24. 24.
    Feldstein AC, Elmer PJ, Smith DH, Herson M, Orwoll E, Chen C, et al. Electronic medical record reminder improves osteoporosis management after a fracture: a randomised controlled trial. J Am Geriatr Soc. 2006;54(3):450–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Goode JV, Swiger K, Bluml BM. Regional osteoporosis screening, referral, and monitoring program in community pharmacies: findings from project ImPACT: osteoporosis. J Am Pharm Assoc (Wash). 2004;44(2):152–60.CrossRefGoogle Scholar
  26. 26.
    Cerulli J, Zeolla MM. Impact and feasibility of a community pharmacy bone mineral density screening and education program. J Am Pharm Assoc (Wash). 2004;44(2):161–7.CrossRefGoogle Scholar
  27. 27.
    Gray M, Rajaei-Dahkordi Z, Ewan M, Wysocki R. Investigating the potential contribution of community pharmacists in identifying, understanding and meeting the bone health needs of patients in collaboration with GPs. IJPP. 2002;10(suppl):R34.Google Scholar
  28. 28.
    Newman ED, Hanus P. Improved bone health behavior using community pharmacists as educators—the geisinger health system community pharmacist osteoporosis education program. Dis Manage Health Outcomes. 2001;9(6):329–35.CrossRefGoogle Scholar
  29. 29.
    Lai P, Chua SS, Chew YY, Chan SP. Effects of pharmaceutical care on adherence and persistence to bisphosphonates in postmenopausal osteoporotic women. J Clin Pharm Ther. 2011;36(5):557–67.PubMedCrossRefGoogle Scholar
  30. 30.
    Lai P, Chua SS, Chan SP. Pharmaceutical care issues encountered by postmenopausal osteoporotic women prescribed bisphosphonates. J Clin Pharm Ther. 2012;37:536–43.PubMedCrossRefGoogle Scholar
  31. 31.
    Dupont WD, Plummer WD. PS. Power and sample size calculation version 3.0 2009 [updated 12 June; cited 2012 30 June]. Available from: http://biostat.mc.vanderbilt.edu/twiki/bin/view/Main/PowerSampleSize.
  32. 32.
    Lai PSM, Chua SS, Chan SP, Low WY. The validity and reliability of the Malaysian osteoporosis knowledge tool in postmenopausal women. Maturitas. 2008;60(2):122–30.PubMedCrossRefGoogle Scholar
  33. 33.
    Lai P, Chua SS, Chan SP, Low WY. Validation of the english version of quality of life questionnaire of the european foundation for osteoporosis (QUALEFFO) in Malaysia. Int J Rheum Diseases. 2008;11:421–9.CrossRefGoogle Scholar
  34. 34.
    Lai P, Chua SS, Chan SP, Low WY. Development and validation of the osteoporosis patient satisfaction questionnaire (OPSQ) (abstract PP1) 1st hospital pharmacy congress 2008.Google Scholar
  35. 35.
    Lai PSM, Chua SS, Chan SP, Low WY, Wong ICK. Development and validation of the osteoporosis patient satisfaction questionnaire (OPSQ). Maturitas. 2010;65:55–63.PubMedCrossRefGoogle Scholar
  36. 36.
    Kamatari M, Koto S, Ozawa N, Urao C, Suzuki Y, Akasaka E, et al. Factors affecting long-term compliance of osteoporotic patients with bisphosphonate treatment and QOL assessment in actual practice: alendronate and risedronate. J Bone Min Metab. 2007;25(5):302–9.CrossRefGoogle Scholar
  37. 37.
    Rizzoli R. Long-term strategy in the management of postmenopausal osteoporosis. Joint Bone Spine. 2007;74:540–3.PubMedCrossRefGoogle Scholar
  38. 38.
    Zhu K, Devine A, Dick IM, Prince RL. Association of back pain frequency with mortality, coronary heart events, mobility, and quality of life in elderly women. Spine. 2007;32(18):2012–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Pauline Siew Mei Lai
    • 1
  • Siew Siang Chua
    • 2
  • Siew Pheng Chan
    • 3
  1. 1.Department of Primary Care Medicine, University of Malaya Primary Care Research Group (UMPCRG), Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
  2. 2.Department of Pharmacy, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
  3. 3.Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia

Personalised recommendations