GRP-150 Prescription of Bisphosphonates in Chronically Institutionalised Patients

Background Osteoporosis is associated with significant morbidity and mortality. Oral bisphosphonates have become a mainstay of treatment, but concerns have emerged that long-term use of these drugs may suppress bone remodelling, leading to unusual fractures. Purpose To assess the intervention on bisphosphonates prescribing of institutionalised geriatric residential centres, by the Prescription Quality Unit (PQU). Materials and Methods The PQU cheques that bisphosphonate treatment is based on patient age, duration of treatment, fracture, concomitant medicines and bisphosphonate prescribed. The PQU reviews the patients’ medicines plans. The results of the review are communicated to the respective physicians, who analyse and discuss the medicines plans on the PQU report. The PQU performs regular clinical sessions and provides the doctors with drug data information (alerts, newsletters, surveys) involved in prescription reviews. Results Interventions in bisphosphonates prescriptions from June 2011 to June 2012: 383 interventions were made (3.7% of all interventions) and 86 were accepted, 22.4% on the bisphosphonates. In 2011 one was accepted (19.11%) while in 2012 27.2% were accepted. The mean age of patients with bisphosphonates was 86 years (10.63% male and 89.37% female). Bisphosphonates represented 4.1% of total prescriptions. The breakdown of bisphosphonates prescriptions was 75.4% alendronate, 4.3% alendronate/cholecalciferol combination, 5.6% ibandronic acid and 14.61% risedronic acid. Conclusions The intervention in bisphosphonates prescribing has been much more effective in 2012 than in 2011 and more intensive updates and drug date information has been provided to physicians in this period. There were no problems in the use of the recommended bisphosphonate, alendronate. No conflict of interest.