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Anti-osteoporosis medication dispensing by clinical commissioning groups in England – an ecological study of variability in practice and of the effect of the Covid-19 pandemic

Janjua, S. S.; Boardman, H. F.; Sami, A.; Johansen, A.; Toh, L. S.; Janjua, Sobia S.; Boardman, Helen F.; Sami, Arvind; Johansen, Antony; Toh, Li Shean; Javaid, M. K.

Anti-osteoporosis medication dispensing by clinical commissioning groups in England – an ecological study of variability in practice and of the effect of the Covid-19 pandemic Thumbnail


Authors

S. S. Janjua

H. F. Boardman

A. Sami

A. Johansen

L. S. Toh

Sobia S. Janjua

Arvind Sami

Antony Johansen

M. K. Javaid



Abstract

Purpose: To investigate whether the rate of Anti-Osteoporosis Medication (AOM) dispensing was related to prevalence of risk factors and hip fracture incidence in the local population. Methods: The Open Prescribing database was used to analyse dispensed AOM at the level of Clinical Commissioning Groups (CCGs) in England. Male Healthy Life Expectancy (MHLE), Female Healthy Life Expectancy (FHLE), the prevalence of smoking and active adults, the incidence of hip fracture and of alcohol related hospital admissions, and local dispensing of a comparator drug (atorvastatin) were considered as predictor variables. Linear and multilinear regression were performed. Using atorvastatin as a comparator, AOM dispensing was compared after the start of the Covid-19 pandemic with the same quarter the previous year. Results: Rates of AOM per 1000 people aged over 65 years in a CCG area varied between 379.2 and 1129.1, with a mean of 670.3. Population risk factors were individually related to the amount of AOM dispensed in an area. Collectively, local activity levels in adults (p=0.042) and local hip fracture incidence (p=0.003) were significantly negatively correlated with rates of AOM dispensed. Rates of alendronate dispensing fell significantly at the start of the Covid-19 pandemic (p < 0.001), whilst atorvastatin dispensing rates significantly increased (p < 0.001). Conclusion: Lower rates of AOM dispensing were seen in areas with a higher proportion of active adults and higher incidence of hip fracture. Multidisciplinary services should be developed to address this care gap with consideration given to local population risk factors. Community pharmacists are ideally placed to play a vital role in osteoporosis management.

Citation

Toh, L. S., Johansen, A., Sami, A., Janjua, S. S., Boardman, H. F., Janjua, S. S., …Javaid, M. K. (2023). Anti-osteoporosis medication dispensing by clinical commissioning groups in England – an ecological study of variability in practice and of the effect of the Covid-19 pandemic. Pharmacoepidemiology and Drug Safety, 32(2), 248-255. https://doi.org/10.1002/pds.5544

Journal Article Type Article
Acceptance Date Sep 16, 2022
Online Publication Date Sep 30, 2022
Publication Date 2023-02
Deposit Date Sep 22, 2022
Publicly Available Date Mar 29, 2024
Journal Pharmacoepidemiology and Drug Safety
Print ISSN 1053-8569
Electronic ISSN 1099-1557
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 32
Issue 2
Pages 248-255
DOI https://doi.org/10.1002/pds.5544
Keywords Pharmacology (medical); Epidemiology
Public URL https://nottingham-repository.worktribe.com/output/11469383
Publisher URL https://onlinelibrary.wiley.com/doi/10.1002/pds.5544
Additional Information This is the peer reviewed version of the following article: Janjua, S.S., Boardman, H.F., Sami, A., Johansen, A., Toh, L.S. and Javaid, M.K. (2022), Anti-Osteoporosis Medication dispensing by Clinical Commissioning Groups in England - an ecological study of variability in practice and of the effect of the Covid-19 pandemic. Pharmacoepidemiol Drug Saf., which has been published in final form at https://doi.org/10.1002/pds.5544.The article must be linked to Wiley’s version of record on Wiley Online Library.

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