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Patients not taking a previously prescribed bone active medication now prescribed medication through Ontario FLS

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Abstract

Summary

In an Ontario fracture liaison service (FLS), we compared medication prescription rates among patients not taking a previously prescribed bone active medication to those with no previous prescription. Prescription rates were similar between these two groups of patients. The FLS provided a secondary opportunity for patients to initiate bone active medication.

Purpose

We compared bone active medication prescription rates among patients presenting to an Ontario fracture liaison service (FLS) who reported not taking a previously prescribed bone active medication to those with no history of prescription.

Methods

Eligible patients were those screened in 39 fracture clinics between July 1, 2017, and September 15, 2019, who were not taking bone active medication at the time of screening and classified as high risk for future fracture based on CAROC or FRAX. Sociodemographic and clinical risk factor variables were assessed at screening. Bone active medication prescription rate was assessed within 6 months of screening and defined as having received a prescription for the medication from either a specialist or primary care provider. In cases where a specialist report was not available, patient self-reported data were collected. The chi-square test of independence was used to assess differences in prescription rates.

Results

Of 17,575 patients screened, eligible patients were 350 with a previous prescription and 2644 without a previous prescription. Compared with patients who reported no previous prescription, those who had a previous prescription were older, more likely to be female and to report a previous fracture, and less likely to smoke. There was no statistically significant difference between the medication prescription rate of patients with a previous prescription (73.7%) compared to patients with no previous prescription (70.7%) (p = 0.157).

Conclusion

A large jurisdiction-wide FLS approach provided a secondary opportunity to patients who were not taking a previously prescribed bone active medication to initiate that medication.

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Acknowledgements

The authors acknowledge with thanks support from the Brookfield Partners Foundation through the Brookfield Chair in Fracture Prevention.

Funding

This study was supported by funding from the Ontario Ministry of Health and Long-Term Care (MOHLTC) through the Ontario Osteoporosis Strategy.

Author information

Authors and Affiliations

  1. Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada

    J. E. M. Sale, A. Yang, T. Inrig, S. Gandhi, V. Elliot-Gibson, R. Sujic & D. Linton

  2. Institute of Health Policy, Management & Evaluation, University of Toronto, 4th Floor – 155 College Street, Toronto, ON, M5T 3M6, Canada

    J. E. M. Sale

  3. Department of Surgery, Faculty of Medicine, University of Toronto, 5th Floor - 149 College Street, Toronto, ON, M5B 1W8, Canada

    J. E. M. Sale

  4. Osteoporosis Canada, Suite 201 – 250 Ferrand Drive, Toronto, ON, M3C 3G8, Canada

    R. Jain & J. Weldon

  5. Department of Surgery, University of Toronto, St. Michael’s Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada

    E. Bogoch

  6. Brookfield Chair in Fracture Prevention, University of Toronto, St. Michael’s Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada

    E. Bogoch

Authors
  1. J. E. M. Sale
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  2. A. Yang
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  3. T. Inrig
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  4. S. Gandhi
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  5. V. Elliot-Gibson
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  6. R. Sujic
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  7. R. Jain
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  8. J. Weldon
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  9. D. Linton
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  10. E. Bogoch
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Corresponding author

Correspondence to J. E. M. Sale.

Ethics declarations

Ethics approval

This study is based on data collected through a quality improvement initiative. Approval for reporting of quality improvement data is not required by the Research Ethics Board at Unity Health Toronto.

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Not applicable.

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Not applicable.

Conflict of interest

The authors Joanna Sale, Alan Yang, Taucha Inrig, Shikha Gandhi, Victoria Elliot-Gibson, Rebeka Sujic, Ravi Jain, Jennifer Weldon, Denise Linton, and Earl Bogoch declare they have no conflict of interest. Earl Bogoch has an unrestricted research grant from Amgen Canada and serves on an advisory board for Amgen Canada.

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Sale, J.E.M., Yang, A., Inrig, T. et al. Patients not taking a previously prescribed bone active medication now prescribed medication through Ontario FLS. Osteoporos Int 33, 2435–2440 (2022). https://doi.org/10.1007/s00198-022-06446-3

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  • DOI: https://doi.org/10.1007/s00198-022-06446-3

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