From our review, we found that compared to “usual care,” a pharmacist intervention that included patient counseling, education, QUS, and physician contact increased central DXA testing and calcium intake among individuals at high risk for osteoporosis. Although not specifically identified within the studies included in our review, a recent RCT identified that DXA testing among women aged 45–54 years significantly increased the use of osteoporosis pharmacotherapy and supplementation with calcium
and vitamin D [42]. Further research is needed to determine if pharmacy selleck kinase inhibitor interventions may also improve osteoporosis treatment initiation. Result from studies included in our review support the use of heel QUS measurement as a feasible BMD screening method that can be utilized JAK inhibitor by pharmacists [36]. Although QUS is no MK-4827 concentration better than questionnaires based on simple risk factors, such as age, body weight, and sex in predicting those likely to have low BMD [43], offering a clinical service
such as BMD measurement may be important for the success of pharmacy-led osteoporosis interventions. In fact, one of the trials included in our review that compared patient satisfaction between two different pharmacist interventions found that peripheral BMD testing was important for patient recruitment and satisfaction [34]. Further research is needed to clarify the importance of BMD measurement on the success of community-based osteoporosis interventions. Our study has many strengths, including a thorough systematic search of the literature, having two independent reviewers search for an abstract
data and having a third author to resolve discrepancies. these We also focused on RCT study designs. Nonetheless, our results are limited to the quality and generalizability of the RCT studies identified. In fact, due to high risk of bias in two of the RCTs under review, non-experimental studies may have yielded similar quality results. If no plan exists to disseminate interventions outside a local setting, lower-quality evidence may be acceptable in quality improvement [44]. Evidence from non-experimental studies may thus be informative for local quality improvement interventions. Our study is also limited by qualitative assessment of risk of bias, which we ascribed as low or high risk based on our assessment of whether or not evidence existed to suggest that results may be biased. We had originally considered two quality assessment tools [45, 46] used in prior reviews of pharmacist interventions [8, 39–41]. However, upon the application of these quality assessment tools, we found that neither differentiated between the studies well.