Pharmacists may contribute to promotion of bone health in persons with ID

By Bernadette Flood, MPSI
Daughters of Charity Service

People with intellectual disabilities (ID) may experience poor bone health due to mobility problems, poor exposure to sunshine, medications that negatively affect bone mineral density, menopause, and poor nutrition. In addition, persons with ID are at risk of falls, resulting in injury and/or bone fracture. However, calcium and vitamin D medicines can help promote good bone health. In addition, other bone health medications can be used in osteoporosis when people have weak bones. There is a need to promote good bone health in the population with ID and pharmacists can help.

What did you do in your research?
As a pharmacist working in a long-term care center with people with ID, and also a member of a Falls Group in the center, I conduct Medication Reviews when persons in the center experience falls. If people need Calcium and Vitamin D, I contact the doctor suggesting that Calcium and Vitamin D be prescribed. If people who fell were at risk of fracture I recommend that the doctor consider prescribing other bone health medications such as bisphosphonates. For this study, I audited the prescriptions for Calcium and Vitamin D and other bone health medications.

What did you find out?
Following the pharmacists’ recommendations, over four years, there was an increase in bone health medications prescribed in the center. After four years 81% of residents were prescribed Calcium and Vitamin D (up from 23%) and 46% of residents were prescribed other bone health medications including bisphosphonates (up from 8%). The pharmacist also advised on the suitability of different preparations of Calcium, Vitamin D, and other bone health medications for people with swallowing difficulties.

What are the take-home messages?
Pharmacists may be 'invisible' in the care of people with ID, but they can help promote bone health in this population. Promoting good bone health can help reduce fractures and promote quality of life for people aging with ID. 

To learn more about these findings contact
Bernadette Flood.

Full Journal Article
Flood, B. (2013). Bone health medication and adults with intellectual disabilities: an audit of bone health medication dispensed by a pharmacist in long-term care. British Journal of Learning Disabilities, 41, 239–240.