In addition, we do not know if discussions between prescribers and their patients about the start of GIOP took place. Possibly, a number of approached patients refused to start osteoporosis prophylaxis. Therefore,
the actual effect of the pharmacist intervention on the physician’s behaviour may have been greater than the reported effect. In addition, we had no clinical data available such as (prior) MM-102 in vitro BMD testing or the occurrence of fractures (history). Guidelines recommend that pre-menopausal women who use 7.5–15 mg of prednisone equivalents for ≥3 months should receive a BMD measurement. However, this study presumably included post-menopausal women (≥50 years). Furthermore, we also have included patients who were dispensed less {Selleck Anti-cancer Compound Library|Selleck Anticancer Compound Library|Selleck Anti-cancer Compound Library|Selleck Anticancer Compound Library|Selleckchem Anti-cancer Compound Library|Selleckchem Anticancer Compound Library|Selleckchem Anti-cancer Compound Library|Selleckchem Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|buy Anti-cancer Compound Library|Anti-cancer Compound Library ic50|Anti-cancer Compound Library price|Anti-cancer Compound Library cost|Anti-cancer Compound Library solubility dmso|Anti-cancer Compound Library purchase|Anti-cancer Compound Library manufacturer|Anti-cancer Compound Library research buy|Anti-cancer Compound Library order|Anti-cancer Compound Library mouse|Anti-cancer Compound Library chemical structure|Anti-cancer Compound Library mw|Anti-cancer Compound Library molecular weight|Anti-cancer Compound Library datasheet|Anti-cancer Compound Library supplier|Anti-cancer Compound Library in vitro|Anti-cancer Compound Library cell line|Anti-cancer Compound Library concentration|Anti-cancer Compound Library nmr|Anti-cancer Compound Library in vivo|Anti-cancer Compound Library clinical trial|Anti-cancer Compound Library cell assay|Anti-cancer Compound Library screening|Anti-cancer Compound Library high throughput|buy Anticancer Compound Library|Anticancer Compound Library ic50|Anticancer Compound Library price|Anticancer Compound Library cost|Anticancer Compound Library solubility dmso|Anticancer Compound Library purchase|Anticancer Compound Library manufacturer|Anticancer Compound Library research buy|Anticancer Compound Library order|Anticancer Compound Library chemical structure|Anticancer Compound Library datasheet|Anticancer Compound Library supplier|Anticancer Compound Library in vitro|Anticancer Compound Library cell line|Anticancer Compound Library concentration|Anticancer Compound Library clinical trial|Anticancer Compound Library cell assay|Anticancer Compound Library screening|Anticancer Compound Library high throughput|Anti-cancer Compound high throughput screening| than 135 DDD prednisone equivalents in the 6 months before baseline (41.2 % in the control group, 37.9 % in the intervention
group), who were possibly not eligible for GIOP according to the Dutch guideline. However, in the Netherlands, patients are frequently dispensed medication for 3 months, and we would have missed these patients if the inclusion period was only 3 months before baseline. Moreover, all patients were required to receive a dispensing for glucocorticoids within 3 months before baseline, and our results show that the cumulative number of DDD prednisone equivalents did not modify the intervention effect. Another limitation of this study was that we were unable to exclude patients where osteoporosis prophylaxis would have been contraindicated or inappropriate (e.g. patients with serious cognitive or renal impairment). Finally, this was a non-blinded RCT with a lack of clinical equipoise between the pharmacists in the intervention group [27]. In other Racecadotril words, it is very likely that all included pharmacists saw the importance of the intervention. As a Etomoxir price result, pharmacists could have been motivated to self-identify patients other than those in
the intervention group who would also benefit from GIOP. This may have masked the effect of the intervention. The present study showed that simple feedback by community pharmacists to physicians about patients eligible for GIOP did not manage to significantly increase the prescribing of bisphosphonates in the overall study population. Subgroup analyses showed a significant increase in males and in patients older than 70 years. However, the absolute number of GIOP-treated patients remained low which calls for more intensive pharmacy-based interventions. Acknowledgments This study was supported by The Netherlands Organization for Health Research and Development (ZonMw; grant number 113101007). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.