Sustainability of a pharmacist-driven pathway for osteoporosis-related fractures on an orthopaedic unit after a 5-year period

Lai, Beryl; Gibb, Catherine; Pink, Jennifer; Thomas, Lewis H.

doi:10.1111/j.2042-7174.2011.00167.x

Cited by 2 publications

(9 citation statements)

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“…13 An application of this approach has been undertaken in South Australia, and is the only published approach of an early in-hospital initiation of appropriate assessment and treatment of osteoporosis that has been successfully implemented and maintained over a prolonged period with the support of the primary orthopaedic team. 8 The sub-optimal approach from the primary teams at Peninsula Health may have greatly contributed to the results seen in this extended study, but the loss of the specialised osteoporosis nurse (who in the previous pilot study contributed to nearly 50% of all osteoporosis assessments) 2 also had an impact.…”

Section: Discussionmentioning

confidence: 90%

“…A combination of a dedicated healthcare provider for osteoporosis with earlier approach in acute‐care settings of a hospital could minimise loss to follow‐up through the non‐attendance of outpatient appointment due to mobility issues that frequently arise following fractures, especially among the elderly population . An application of this approach has been undertaken in South Australia, and is the only published approach of an early in‐hospital initiation of appropriate assessment and treatment of osteoporosis that has been successfully implemented and maintained over a prolonged period with the support of the primary orthopaedic team . The sub‐optimal approach from the primary teams at Peninsula Health may have greatly contributed to the results seen in this extended study, but the loss of the specialised osteoporosis nurse (who in the previous pilot study contributed to nearly 50% of all osteoporosis assessments) also had an impact.…”

Section: Discussionmentioning

confidence: 99%

“…This approach has been advocated and implemented in association with other acute presentations of chronic diseases, such as acute coronary syndrome. A number of Australian hospital pharmacy departments have identified this issue and have trialled several strategies to improve on previous management rates for osteoporosis . In 2010, an academic detailing and algorithm‐based approach, the PRO‐OSTEO project, was trialled at Peninsula Health's orthopaedic ward.…”

Section: Introductionmentioning

confidence: 99%

“…A number of Australian hospital pharmacy departments have identified this issue and have trialled several strategies to improve on previous management rates for osteoporosis. 8,9 In 2010, an academic detailing and algorithm-based approach, the PRO-OSTEO project, was trialled at Peninsula Health's orthopaedic ward. This pilot study demonstrated highly improved assessment and treatment rates, in accordance with current guidelines.…”

Section: Introductionmentioning

confidence: 99%

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PRO‐OSTEO Extend I study (improving osteoporosis management in the acute and rehabilitation settings): multicentre audit

Banakh

Chao²

2015

Pharmacy Practice and Res

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Background Osteoporosis contributes to a large number of admissions to hospitals after minimal‐trauma fractures but is poorly recognised as an underlying cause of admissions and may be inadequately managed following hospitalisation. Aim The aim of this study was to examine osteoporosis management across Peninsula Health, assessing the effect of the introduction of a standard form to guide osteoporosis management after minimal‐trauma fractures. Method This was a retrospective cohort study measuring rates of osteoporosis assessment and treatment for patients admitted with minimal‐trauma fractures. Two periods were compared (in 2012 and 2013), before and after the introduction of an osteoporosis management form that allowed a pharmacist‐driven approach to management. The study end points were the extents of use of the osteoporosis form and the rates of osteoporosis assessment and treatment. Results Osteoporosis assessment and treatment rates varied widely across Peninsula Health, with acute wards such as the emergency departments providing no assessment or treatment (before and after the intervention). The uptake of the osteoporosis management form was negligible in the post‐intervention period. The overall 2‐year mortality rate was 7.4% following any fracture within 2 years of admission, and up to 33% following a hip or neck of femur fracture at some sites. Conclusion Osteoporosis management remained inadequate in the hospital settings despite intervention. Strategies such as ongoing prescriber education and employment of a local change champion specialised in osteoporosis management with support from all departments may be needed to achieve the aim of lowering the morbidity and mortality associated with this disease.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

PRO‐OSTEO Extend I study (improving osteoporosis management in the acute and rehabilitation settings): multicentre audit

Banakh

Chao²

2015

Pharmacy Practice and Res

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“…Most studies focused on the adult population ( n = 16) [ 51 , 55 – 57 , 59 , 61 , 62 , 64 , 66 – 71 , 73 , 74 ], while fewer had a pediatric focus ( n = 8) [ 53 , 58 , 60 , 63 , 65 , 72 , 75 , 77 ], and one reported on the neonatal intensive care unit [ 76 ]. Thirteen of the included studies took place in acute care [ 55 , 57 , 60 – 62 , 66 , 68 , 69 , 71 , 73 , 75 – 77 ], 11 in tertiary care [ 51 , 53 , 56 , 58 , 59 , 63 – 65 , 70 , 72 , 74 ], and 1 in ambulatory care [ 67 ]. Fifty-two percent ( n = 13) [ 53 , 56 – 58 , 61 – 63 , 65 , 67 , 71 , 75 – 77 ] of the included studies were published in the USA, with the remaining ( n = 12) published in Australia ( n = 2) [ 68 , 74 ], Canada ( n = 2) [ 60 , 69 ], Italy ( n = 2) [ 66 , 72 ], Sweden ( n = 2) [ 59 , 73 ], Spain ( n = 1) [ 70 ]...…”

Section: Resultsmentioning

confidence: 99%

Knowledge translation strategies to support the sustainability of evidence-based interventions in healthcare: a scoping review

Flynn,

Cassidy,

Dobson

et al. 2023

Implementation Sci

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Background Knowledge translation (KT) strategies are widely used to facilitate the implementation of EBIs into healthcare practices. However, it is unknown what and how KT strategies are used to facilitate the sustainability of EBIs in institutional healthcare settings. Objectives This scoping review aimed to consolidate the current evidence on (i) what and how KT strategies are being used for the sustainability of EBIs in institutional healthcare settings; (ii) the reported KT strategy outcomes (e.g., acceptability) for EBI sustainability, and (iii) the reported EBI sustainability outcomes (e.g., EBI activities or component of the intervention continue). Methods We conducted a scoping review of five electronic databases. We included studies describing the use of specific KT strategies to facilitate the sustainability of EBIs (more than 1-year post-implementation). We coded KT strategies using the clustered ERIC taxonomy and AIMD framework, we coded KT strategy outcomes using Tierney et al.’s measures, and EBI sustainability outcomes using Scheirer and Dearing’s and Lennox’s taxonomy. We conducted descriptive numerical summaries and a narrative synthesis to analyze the results. Results The search identified 3776 studies for review. Following the screening, 25 studies (reported in 27 papers due to two companion reports) met the final inclusion criteria. Most studies used multi-component KT strategies for EBI sustainability (n = 24). The most common ERIC KT strategy clusters were to train and educate stakeholders (n = 38) and develop stakeholder interrelationships (n = 34). Education was the most widely used KT strategy (n = 17). Many studies (n = 11) did not clearly report whether they used different or the same KT strategies between EBI implementation and sustainability. Seven studies adapted KT strategies from implementation to sustainability efforts. Only two studies reported using a new KT strategy for EBI sustainability. The most reported KT strategy outcomes were acceptability (n = 10), sustainability (n = 5); and adoption (n = 4). The most commonly measured EBI sustainability outcome was the continuation of EBI activities or components (n = 23), followed by continued benefits for patients, staff, and stakeholders (n = 22). Conclusions Our review provides insight into a conceptual problem where initial EBI implementation and sustainability are considered as two discrete time periods. Our findings show we need to consider EBI implementation and sustainability as a continuum and design and select KT strategies with this in mind. Our review has emphasized areas that require further research (e.g., KT strategy adaptation for EBI sustainability). To advance understanding of how to employ KT strategies for EBI sustainability, we recommend clearly reporting the dose, frequency, adaptations, fidelity, and cost of KT strategies. Advancing our understanding in this area would facilitate better design, selection, tailored, and adapted use of KT strategies for EBI sustainability, thereby contributing to improved patient, provider, and health system outcomes.

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Sustainability of a pharmacist-driven pathway for osteoporosis-related fractures on an orthopaedic unit after a 5-year period

Abstract: The pharmacist-driven osteoporosis pathway at The Queen Elizabeth Hospital has sustained the rate of prescription for osteoporosis therapy over a prolonged period of time.

Cited by 2 publications

References 12 publications

PRO‐OSTEO Extend I study (improving osteoporosis management in the acute and rehabilitation settings): multicentre audit

PRO‐OSTEO Extend I study (improving osteoporosis management in the acute and rehabilitation settings): multicentre audit

Knowledge translation strategies to support the sustainability of evidence-based interventions in healthcare: a scoping review

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