ASSESSMENT OF THE LEBANESE COMMUNITY PHARMACIST KNOWLEDGE, PRACTICE AND BARRIERS REGARDING THE PREVENTION OF OSTEOPOROSIS

Osteoporosis is a silent skeletal disease that is often recognized when fractures occur as a result of minimal trauma. Limited studies have assessed the degree of pharmacists’ involvement in osteoporosis prevention, risk-assessment/screening and physician referrals. To assess the Lebanese community pharmacists’ knowledge, practice and barriers regarding osteoporosis prevention. Secondary aim is to assess the pharmacists’ ability to identify high-risk patients who should be referred for bone mineral density (BMD) testing. A cross-sectional study was carried out in Beirut, Lebanon between September and October 2020 using self-administered questionnaire. Pharmacists completed a multi-component questionnaire that consisted of socio-demographic characteristics, practices, knowledge and barriers in relation to osteoporosis prevention and high-risk identification. Frequencies and proportions were used to describe the data. Simple and multiple linear regression analysis were used to examine the determinants of knowledge in the study population. The majority of pharmacists were rarely/never involved in counseling patients on osteoporosis risk factors (57.5%) and healthy lifestyle habits (62.5%) as well as engaging in risk-assessment (63.1%), screening using Fracture Risk Assessment Tool (FRAX) (0%) and physician referrals (sometimes-55.6%). In addition, pharmacists were also scarcely involved in reducing the risk of falls (55.1-59.4%). Pharmacists were knowledgeable about osteoporosis prevention however had important gaps in the diseases that increase osteoporosis risk as well as in FRAX tool, indications that require BMD testing and increased risk of fall medications. Significant predictors of knowledge were receiving postgraduate training on osteoporosis and earning the pharmacy degree from a university in Lebanon. Barriers to providing osteoporosis services included lack of time, staff, space, patients’ interest in prevention activities and limited inter-professional collaboration. The study findings provided important insights on the practices, knowledge and barriers of pharmacists regarding osteoporosis prevention and high-risk identification. Concerted efforts of multiple stakeholders are needed to promote the active role of community pharmacists in order to reduce the risk of morbidity, mortality and health-care costs associated with osteoporosis and related fractures.