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Sadowski CA, Lyder C, Yuksel N. Bisphosphonates for Osteoporosis in Patients with Renal Insufficiency: Pharmacists' Practices and Beliefs. Can J Hosp Pharm. 2016;69(1):14-22doi: 10.4212/cjhp.v69i1.1518.
Sadowski, C. A., Lyder, C., & Yuksel, N. (2016). Bisphosphonates for Osteoporosis in Patients with Renal Insufficiency: Pharmacists' Practices and Beliefs. The Canadian journal of hospital pharmacy, 69(1), 14-22. https://doi.org/10.4212/cjhp.v69i1.1518
Sadowski, Cheryl A, et al. "Bisphosphonates for Osteoporosis in Patients with Renal Insufficiency: Pharmacists' Practices and Beliefs." The Canadian journal of hospital pharmacy vol. 69,1 (2016): 14-22. doi: https://doi.org/10.4212/cjhp.v69i1.1518
Sadowski CA, Lyder C, Yuksel N. Bisphosphonates for Osteoporosis in Patients with Renal Insufficiency: Pharmacists' Practices and Beliefs. Can J Hosp Pharm. 2016 Jan-Feb;69(1):14-22. doi: 10.4212/cjhp.v69i1.1518. PMID: 26985084; PMCID: PMC4777575.
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Can J Hosp Pharm. 2016 Jan-Feb;69(1):14-22. doi: 10.4212/cjhp.v69i1.1518.

Bisphosphonates for Osteoporosis in Patients with Renal Insufficiency: Pharmacists' Practices and Beliefs.

The Canadian journal of hospital pharmacy

Cheryl A Sadowski, Catherine Lyder, Nesé Yuksel

Affiliations

  1. BSc(Pharm), PharmD, FCSHP, is Associate Professor with the Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta.
  2. BScPharm, MHSA, is Coordinator, Professional and Membership Affairs, Canadian Society of Hospital Pharmacists, Edmonton, Alberta.
  3. BScPharm, PharmD, FCSHP, NCMP, is Associate Professor, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta.

PMID: 26985084 PMCID: PMC4777575 DOI: 10.4212/cjhp.v69i1.1518

Abstract

BACKGROUND: Clinicians often face challenges in deciding how to treat osteoporosis in patients with chronic kidney disease. As background to offering guidance to health care providers, it is important to understand their practices and beliefs.

OBJECTIVES: To describe the practices and beliefs of pharmacists regarding use of bisphosphonates for patients with osteoporosis and chronic kidney disease.

METHODS: A cross-sectional survey of pharmacists working in hospitals and related health care settings was conducted. A 34-item online questionnaire was developed consisting of 4 sections: demographic characteristics, practices, beliefs, and comfort level with making decisions about osteoporosis treatment. An e-mail invitation was sent to members of the Canadian Society of Hospital Pharmacists (n = 2499) in November 2012.

RESULTS: A total of 367 pharmacists completed the survey. Most of the respondents were women (258 [70%]), had more than 10 years in practice (213 [58%]), and were providing care to 1 or more osteoporosis patients per week (212 [58%]). Over one-third (150 [41%]) stated that they would use a bisphosphonate for patients with creatinine clearance (CrCl) of 15-30 mL/min, but more than half (207 [56%]) stated that they would avoid a bisphosphonate (and recommend another medication) for patients with CrCl below 15 mL/min. Forty-eight percent (176/363) agreed that oral bisphosphonates could be used for patients with renal failure (defined as CrCl < 30 mL/min), so long as dosage adjustments are made. More than half (206/363 [57%]) believed that the adverse effects of oral bisphosphonates increase for patients with renal failure. Respondents expressed a low level of comfort in assessing and initiating osteoporosis treatment for patients with renal failure.

CONCLUSIONS: Pharmacists had varying beliefs about managing osteoporosis in patients with chronic kidney disease. This study highlights the need for practice tools and targeted education addressing the use of bisphosphonates for these patients.

Keywords: beliefs; bisphosphonates; osteoporosis; pharmacists; renal insufficiency

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