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Effects of quality indicator monitoring for glucocorticoid‐induced osteoporosis and trends of drug treatment in a Japanese hospital
Author(s) -
Suda Masei,
Suyama Yasuhiro,
Ohde Sachiko,
Tsuda Tokutaro,
Sawada Haruki,
Kishimoto Mitsumasa,
Okada Masato
Publication year - 2018
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13310
Subject(s) - medicine , osteoporosis , glucocorticoid , drug , intensive care medicine , pharmacology , emergency medicine , pediatrics
Aims Globally, the appropriate prescription rate for glucocorticoid‐induced osteoporosis ( GIOP ) is low. Thus, we aimed to examine the improvement in real‐world GIOP care using a hospital‐wide systematic approach with quality indicator ( QI ) monitoring. Methods We defined a novel QI for GIOP care for the prescription rate of anti‐osteoporotic drugs according to 2010 American College of Rheumatology GIOP management recommendations, with the target being patients prescribed ≥7.5 mg prednisolone daily or its equivalent for ≥3 months. We monitored the glucocorticoid and osteoporotic medication dose for all patients who visited our hospital. From May 2011, we began interventions to improve QI : monthly QI monitoring providing QI ‐trend feedback to each department in a hospital‐wide QI meeting every 3 months and organizing lectures on GIOP . We retrospectively analyzed QI trends from 2010 to 2013. We categorized groups by sex and age for subanalyses: group A, men; group B, women, aged <50 years; group C, women, aged ≥50 years. Results The numbers of participants were 401, 420, 520 and 513 in 2010, 2011, 2012 and 2013, respectively, with pooled QI rates of 45.8%, 51.3%, 55.0% and 54.8%, respectively. Changes in QI between each consecutive 2 years were statistically significant. Subanalyses showed statistically significant QI improvements in groups A and C. We observed a decreasing trend of daily bisphosphonate use throughout the study period, especially at the Immuno‐Rheumatology Center. Conclusions Quality indicator monitoring for GIOP significantly improved appropriate anti‐osteoporotic drug prescriptions, especially in men and postmenopausal women.