Single pharmacy governed denosumab home administration: optimal adherence by means of a fracture liaison service (FLS) and home care collaboration.

Autor: van den Berg P; Department of Orthopedics and Surgery, Fracture Liaison Service, Reinier de Graaf Gasthuis, Delft, The Netherlands. pberg@rdgg.nl., Sluiter E; Zuid-Hollandse Apotheek Service (ZHAS), The Hague, The Netherlands., Oosterveld MH; Zuid-Hollandse Apotheek Service (ZHAS), The Hague, The Netherlands., van Leerdam M; Bare Statistics, Stompetoren, The Netherlands., Langendijk P; Department of Hospital Pharmacy, Reinier de Graaf Gasthuis, Delft, The Netherlands., Schweitzer DH; Department of Internal Medicine and Endocrinology, Reinier the Graaf Gasthuis, Delft, The Netherlands.
Jazyk: angličtina
Zdroj: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA [Osteoporos Int] 2022 Apr; Vol. 33 (4), pp. 881-887. Date of Electronic Publication: 2021 Nov 13.
DOI: 10.1007/s00198-021-06234-5
Abstrakt: Low adherence for denosumab (Dmab, Prolia®) is of major concern. Dutch pharmacies deliveries were calculated recently being 76.5% for a total of 3 injections.
Introduction: Comparing a model where the prescriber maintains responsibility for adherence (model HC1) (Dmab is purchased and dispensed by patient's own community pharmacy and administered through a home care service (HC)) or an all-in-one model where the pharmacist maintains responsibility for the adherence (Dmab is purchased, dispensed, and administered by a pharmacist's HC) (HC2).
Methods: We counted the number of Dmab injections, follow-up appointments on time, Dmab administrations delayed to a maximum of 60 days, the number of Dmab discontinuations, and all causes legally traceable under EU privacy act (EDPR).
Results: Home care started by 2014 (study closure in 2021) and included 711 Dmab injections to 256 unique patients: HC1: 536 and HC2: 175 orders. The whole group received on average 2.8 Dmab injections by consistent intervals of about 182 days. Average administration after the latest Dmab injection: 272.8 days (HC1: 362.0 and HC2: 124.0 days). Administration of a subsequent injection > 60 days occurred in 26.6% (HC1: 38.8% and HC2: 6.2%; OR = 9.49). After adjustment for no more than three Dmab injections administered per patient, it occurred in 27.3% (HC1: 51.8% and HC2 4.4%; OR = 23.34).
Conclusion: It was possible to achieve 94% adherence for Dmab injections treatment just by transferring the complete supply chain to one pharmacy-initiated home care provider after treatment initiation by either a physician or FLS health care professional.
(© 2021. International Osteoporosis Foundation and National Osteoporosis Foundation.)
Databáze: MEDLINE
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