Background and Importance Bisphosphonate treatment lasting more than 5 years(BP5y) in patients without previous fractures and/or low risk of fracture does not confer additional benefits. The antiresorptve effect is maintained for a time after drug discontinuation and the side-effects risk is minimised. The increased risk of rare and long-term side-effect associated with the prolonged use of bisphosphonates has been reason of safety notes issued by the Spanish Agency for Medicines and Health Products and other regulatory agencies. So, a re-evaluation of the treatment is necessary considering the benefits and risks for the patient individually, especially after 5 years of use.
Aim and Objectives The aim of the present study was to identify patients in treatment with BP5y and to evaluate the acceptance of pharmaceutical intervention(PI) over deprescribing in primary prevention.
Material and Methods By means of the primary care data exploitation platform (Digitalis®) and after reviewing the electronic prescription, patients on treatment with BP5y were identified until December-2021. Patients >85-years-old were selected due to their increased frailty, comorbidities and polypharmacy. The physicians were informed via the informative sheets of the primary care information system (Turriano®) about the susceptible condition to deprescribing after more than 5 years of continuous treatment in primary prevention. Seven months later, acceptance degree of PI was assessed.
Results At the start of the study, 186 patients were identified in treatment with BP5y, 51 of whom were >85 years-old. Finally, PI was performed on 43 patients belonging to the selected health centres. Seven months later, bisphosphonate withdrawal was observed in 10 patients, with a prescribing doctors acceptance rate of 23% (10/43). Currently, 33 patients continue with such treatment either out of necessity or due to lack of knowledge of PI. Only one of the 8 patients without PI (12.5%) had bisphosphonate discontinuation.
Conclusion and Relevance The monitoring, analysis of treatments with BF5y and the corresponding PI have promoted the deprescription in almost a quarter of the cases, creating the need to extend the study to the rest of the patients. The importance of the pharmacist in the review of treatments is highlighted, as well as the interdisciplinary collaboration with physicians to achieve a safe use of the drug.
Conflict of Interest No conflict of interest
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