{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:12:39Z","timestamp":1788952359573,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Denosumab and bisphosphonates are the main treatments for osteoporosis in residential aged care (RAC). Strict adherence to 6\u2010monthly denosumab dosing is critical as delayed doses can result in bone resorption and vertebral fractures. If denosumab is ceased, then a bisphosphonate is recommended to avoid vertebral fractures. We aimed to examine adherence to denosumab dosing guidelines, practices of ceasing or switching to bisphosphonate treatment and how these vary in Australian RAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study using routinely collected electronic medication administration data. Between 2018 and 2022, a total of 10\u2009674 residents were treated for osteoporosis with denosumab or bisphosphates in 413 RAC homes. Non\u2010adherence to denosumab treatment guidelines was defined as either a dosing interval of &gt;210\u2009days or cessation of denosumab without bisphosphonate replacement (residents with \u226512\u2010month follow\u2010up). Secondary outcomes were residents who ceased or switched from a bisphosphonate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 9281 residents (86.9%) were administered denosumab, and 5986 were administered more than one dose. In total, there were 15\u2009040 intervals between consecutive denosumab doses, and 14.8% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092222) were longer than recommended by guidelines, affecting 20.0% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091881) of residents on denosumab. Of residents who ceased denosumab, 98.2% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009833) were not administered a bisphosphonate. Of residents who ceased a bisphosphonate, 58.9% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009279) switched to denosumab, with a median of 8\u00a0days (IQR: 18) between doses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant gaps exist in the treatment of osteoporosis with denosumab and bisphosphonates in RAC placing residents at risk. Reasons for and interventions to address these gaps should be urgently explored, leveraging digital systems and RAC pharmacist services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70574","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:55:49Z","timestamp":1777010149000},"page":"2819-2827","source":"Crossref","is-referenced-by-count":1,"title":["Mind the gap: Adherence to denosumab dosing and cessation guidelines in Australian residential aged care"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3060-6437","authenticated-orcid":false,"given":"Marea","family":"O'Donnell","sequence":"first","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna I.","family":"Westbrook","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayzidur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Meulenbroeks","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasir","family":"Wabe","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian D.","family":"Cameron","sequence":"additional","affiliation":[{"name":"John Walsh Centre for Rehabilitation Research Northern Sydney Local Health District  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Morgan","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Medicine Bond University  Gold Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena Z.","family":"Raban","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"M.S.Bohingamu J.J.Watts K.GebremariamandJ.Abimanyi\u2010Ochom Osteoporosis and fractures in Australia. 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