Exploring the current and future role of the pharmacists in osteoporosis screening and management in Malaysia

Healthcare professionals' perspectives and experiences of osteoporosis medication treatment: a qualitative systematic review

This systematic review aimed to explore healthcare professionals' (HCPs) experiences and perspectives of osteoporosis medication treatment through thematic synthesis of qualitative studies. We found themes about how osteoporosis is perceived as a disease, treatment decision-making and what empowers HCPs to provide the best possible care.

PURPOSE

The systematic review aimed to describe the perspectives and experiences of HCPs regarding osteoporosis medication treatment.

METHODS

We performed searches in four electronic databases (Medline, Embase, PsycINFO and CINAHL) from database inception until May 2023 in any language. Data was analysed through inductive thematic synthesis.

RESULTS

We included 27 primary studies that incorporated the views of 495 different HCPs. The following themes were identified: low-priority disease, challenges in treatment decision-making, minimising drug burden, conscious of communication barriers, fragmented care and advice, confidence through experience and collaboration.

CONCLUSIONS

HCPs were enthusiastic about optimising osteoporosis care through interprofessional collaboration and expertise, as well as educating and monitoring patients on treatment. They advocated for safety, comfort and reducing overall drug burden, especially in older patients with comorbidities. However, they had differences in opinions regarding who has responsibility for diagnosing and treating osteoporosis and struggled to provide the best possible care due to competing priorities, limited time and lack of adequate knowledge or evidence. The findings highlight the important and complementary role of different HCPs in osteoporosis treatment through a multidisciplinary model of care.

Awareness of osteoporosis risk assessment tools and screening recommendations among community pharmacists in Malaysia

Background The incidence of osteoporosis in Malaysia is increasing due to a fast-ageing population. Because of its silent nature, various osteoporosis risk assessment tools exist to detect high-risk patients and facilitate referrals for bone mineral density measurements. As an accessible point of contact, community pharmacists would benefit from the utilization of these tools and familiarity with guideline recommendations for osteoporosis screening. Aim This study aimed to investigate the awareness of osteoporosis risk assessment tools, practice behaviour towards osteoporosis, and knowledge of guideline recommendations among community pharmacists in the Klang Valley, Malaysia. Setting Community pharmacies. Methods This study was a cross-sectional study which sampled 284 community pharmacists practicing in the Klang Valley, using a stratified sampling approach. The study was conducted using a self-administered questionnaire which was divided into three sections: demographic data, knowledge of osteoporosis risk assessment tools and guideline recommendations, and practice behaviour towards osteoporosis. Practice behaviour was assessed with 15 items using a 5-point Likert scale. Main outcome measure. Proportion of respondents aware of osteoporosis risk assessment tools and respondent knowledge on guideline recommendations for osteoporosis screening. Results A total of 284 community pharmacists participated in the study. 84.1% of the respondents were aware of at least one risk assessment tool. However, only a small proportion of pharmacists (14.9%) regularly used these tools in their practice. Respondents perceived these tools to be relevant and beneficial, but perception towards their accessibility, ease-of-use, and administration time was mixed, suggesting unfamiliarity. Respondents preferred to conduct clinical assessments based on risk factors, with respondents identifying a mean of 10.1 ± 3.4 out of 15 risk factors. However, several clinically relevant risk factors were frequently unidentified. Knowledge of guideline recommendations among respondents was low. Conclusion There is some awareness of osteoporosis risk assessment tools but use in practice remains low among community pharmacists in Malaysia. There is potential to increase the use of these tools and knowledge of recommendations for osteoporosis screening and referral among community pharmacists.

Knowledge, attitude and practice of community pharmacists towards nutrition counseling

Background The World Health Organization considers health promotion a top health service priority. Nutrition, weight management and physical activity are necessary health promotion strategies to improve overall quality of life and decrease the personal and societal consequences or poor health. Community pharmacists are in the best position to implement health promotion strategies due to their excellent accessibility and the lack of a requirement to make an appointment to interact with them. Enabling people to change their lifestyle and control their health through nutrition education and counseling is a great opportunity for community pharmacists to promote health. Nutrition counseling as a part of clinical nutrition therapy aims to provide dietary advice and to assist the selection of appropriate over-the-counter supplements. Objective To investigate the community pharmacist role in nutrition counseling and identify the barriers and strategies to improve nutrition counseling in Egypt. Setting Community pharmacies in Egypt. Methods A descriptive, cross-sectional study was conducted with a knowledge, attitude, and practice survey. A specially developed and validated questionnaire was used to collect data via face-to-face structured interviews. Primary outcomes Pharmacists' knowledge about, attitudes towards and practice of nutrition counseling. Results A total of 368 community pharmacists participated in this study, with a response rate of 73.6%. A total of 255 (69.3%) of the participants considered medical nutrition therapy a part of a pharmacist's duties. Only 146 (39.7%) of the participants believed that dietary supplements positively impact public health. According to 321 (87.2%) of the participants, the lack of pharmacists' expertise in nutrition counseling was the main barrier to nutrition counseling. Conclusions The majority of the participating community pharmacists had positive attitudes towards their role in nutritional assessment and medical nutrition therapy. There is a need to improve the nutritional knowledge of community pharmacists in Egypt. The current practice of community pharmacists in nutrition counseling is limited to adults. Obesity, diabetes and hypertension were the main medical conditions of the patients who received nutrition counseling from the community pharmacists. Inadequate knowledge in nutrition and the unavailability of educational materials were the main barriers to nutrition counseling.