4CPS-227 Management of osteoporosis in rheumatology day hospital: does the clinical pharmacist have a role to play?

<h3>Background and Importance</h3> A multidisciplinary day hospitalisation (DH) dedicated to osteoporosis was established in our medical centre in May 2023. Clinical pharmacist provides individualised care through a medication review, a medication reconciliation and a pharmaceutical consultation (PC). <h3>Aim and Objectives</h3> The study aimed to assess the pharmaceutical impact in the management of patients with osteoporosis. <h3>Material and Methods</h3> All patients admitted to day hospital have a PC and the following points are discussed: information about disease and osteoporosis treatment and hygienic-dietary rules. Pharmaceutical interventions (PIs) are referred to the rheumatologist and general practitioners (GPs). Pharmaceutical reports are sent to GPs and community pharmacists. Data from patients who had a PC from May 2023 to May 2024 were extracted from the electronic medical record and pharmaceutical report and analysed. <h3>Results</h3> Over the study period, 78 patients (73% women) with a median age of 77 (51–97) years had a PC. Several drugs were presented to patients (mechanism of action, side effects, precautions for use): zoledronic acid (66.7%), teriparatide (12.8%), risedronate (11.5%), desonumab (6.4%), raloxifene (2.6%). Fall-increasing risk drugs were prescribed for 44.8% patients (benzodiazepine (10); antidepressant (10); opioid (8); alpha-blocker (8); hypnotic (7); diuretic (7); nonsteroidal anti-inflammatory drug (1)), and drug induced osteoporosis were prescribed for 61.5% patients (proton pump inhibitors (PPIs) (34); corticosteroids (13); chemotherapy (1)). In total, 63 PIs were performed (0.8 PI per patient): deprescription (opioid (9), benzodiazepine (8), PPIs (7)); dose adjustment (hypnotic (4), cholecalciferol (3), PPIs (1)); proposition to add a drug (calcium (15), cholecalciferol (10)); administration schedule adjustment (calcium (2)); galenic form (calcium (1)); optimisation of therapeutic strategy (antihypertensives (3)). Thirty-one PIs were performed to the rheumatologist and were accepted (100%), 32 IPs were performed to GPs. Smoking (10) and alcoholic patients (5) were offered a smoking and alcohol cessation programme. The 1 year hospitalisation rate for falls and fractures is 5.1%. <h3>Conclusion and Relevance</h3> This study highlights the positive impact of a clinical pharmacist intervention in an osteoporosis day hospital on therapeutic optimisation and patients education about their disease and treatments. All PIs referred to the rheumatologist were accepted. A study is undergoing to evaluate the acceptance rate of the PIs referred to GPs. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest