{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:14:07Z","timestamp":1786115647628,"version":"build-2736575974"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Osteoporos"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Pharmacist-led interventions significantly improved denosumab adherence in patients with osteoporosis at an academic medical center, reducing non-adherence from 20.8 to 4.9%. This quality improvement initiative included pharmacist-led medication counseling and laboratory monitoring, highlighting the effectiveness of pharmacist-physician collaboration in preventing rebound-associated vertebral fractures and enhancing patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Interrupting or delaying denosumab beyond 7 months (210\u00a0days) from the last injection leads to transient increase in bone turnover known as rebound phenomenon, resulting in rapid loss of bone density and increased risk of vertebral fracture(s), now known as\n                      <jats:italic>rebound-associated vertebral fractures (RAVF)<\/jats:italic>\n                      . Numerous studies suggest that clinical pharmacist participation in chronic disease state management leads to an increase in medication adherence and positive clinical outcomes. We evaluated the impact of a clinical pharmacist intervention on adherence to optimal denosumab timing for patients with osteoporosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The model for improvement was used to design and evaluate this quality improvement project. This study analyzed 143 patients receiving denosumab therapy in an osteoporosis clinic every 6\u00a0months for the indication of osteoporosis. At baseline, 21% of patients receiving denosumab did not receive the medication at optimal time intervals for clinical effectiveness. An administration was considered\n                      <jats:italic>correct<\/jats:italic>\n                      or on time if denosumab was given within 210\u00a0days of the last injection received. If the injection was given outside this window, it was considered\n                      <jats:italic>incorrect<\/jats:italic>\n                      administration. The incidence of\n                      <jats:italic>correct<\/jats:italic>\n                      and\n                      <jats:italic>incorrect<\/jats:italic>\n                      administrations was gathered to calculate the non-adherence rate. Clinical pharmacist interventions included patient counseling and electronic\u00a0dosing reminders and phone calls. The aim of this study was to reduce the nonadherence rate from 20.8% to less than 5.0% by July 31, 2023.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>With these interventions, the number of correct administrations between incorrect administrations improved from an average of 3.3 to 13.1. These effects became visible about 10\u00a0weeks after the second intervention and correspond to a reduction in nonadherence rate from 20.8 to 4.9% by July 31, 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pharmacist-physician collaboration can reduce the nonadherence rate for drugs such as denosumab, interruption of which can result in serious consequences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11657-026-01725-6","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T04:22:04Z","timestamp":1785990124000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of clinical pharmacist-led interventions on denosumab adherence"],"prefix":"10.1007","volume":"21","author":[{"given":"Anna","family":"Zuschnitt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Lightheart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Myers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amna Nabeel","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"1725_CR1","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1007\/s00198-020-05334-y","volume":"31","author":"EM Leweicki","year":"2020","unstructured":"Leweicki EM, Chastek B, Sundquist K et al (2020) Osteoporotic fracture trends in a population of US managed care enrollees from 2007 to 2017. Osteoporos Int 31:1299\u20131304. https:\/\/doi.org\/10.1007\/s00198-020-05334-y","journal-title":"Osteoporos Int"},{"issue":"3","key":"1725_CR2","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1007\/s00198-017-4345-0","volume":"29","author":"EM Leweicki","year":"2018","unstructured":"Leweicki EM, Wright NC, Curtis JR et al (2018) Hip fracture trends in the United States, 2002 to 2015. Osteoporos Int 29(3):717\u2013722. https:\/\/doi.org\/10.1007\/s00198-017-4345-0","journal-title":"Osteoporos Int"},{"issue":"12","key":"1725_CR3","doi-asserted-by":"publisher","first-page":"2137","DOI":"10.1007\/s00198-024-07236-9","volume":"35","author":"AN Khan","year":"2024","unstructured":"Khan AN, Jones RB Jr, Khan N, Yang YX, Adler RA (2024) Trends in hip fracture rates in US male veterans. Osteoporos Int 35(12):2137\u20132144. https:\/\/doi.org\/10.1007\/s00198-024-07236-9","journal-title":"Osteoporos Int"},{"issue":"2","key":"1725_CR4","doi-asserted-by":"publisher","first-page":"182","DOI":"10.7326\/M22-0684","volume":"176","author":"C Ayers","year":"2023","unstructured":"Ayers C, Kansagara D, Lazur B, Fu R, Kwon A, Harrod C (2023) Effectiveness and safety of treatments to prevent fractures in people with low bone mass or primary osteoporosis: a living systematic review and network meta-analysis for the American College of Physicians. Ann Intern Med 176(2):182\u2013195. https:\/\/doi.org\/10.7326\/M22-0684","journal-title":"Ann Intern Med"},{"issue":"7","key":"1725_CR5","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/S2213-8587(17)30138-9","volume":"5","author":"HG Bone","year":"2017","unstructured":"Bone HG, Wagman RB, Brandi ML et al (2017) 10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension. Lancet Diabetes Endocrinol 5(7):513\u2013523. https:\/\/doi.org\/10.1016\/S2213-8587(17)30138-9","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"5","key":"1725_CR6","doi-asserted-by":"publisher","first-page":"1435","DOI":"10.1210\/clinem\/dgz321","volume":"105","author":"H Lyu","year":"2020","unstructured":"Lyu H, Zhao SS, Yoshida K et al (2020) Delayed denosumab injections and bone mineral density response: an electronic health record-based study. J Clin Endocrinol Metab 105(5):1435\u20131444. https:\/\/doi.org\/10.1210\/clinem\/dgz321","journal-title":"J Clin Endocrinol Metab"},{"issue":"7","key":"1725_CR7","doi-asserted-by":"publisher","first-page":"516","DOI":"10.7326\/M20-0882","volume":"173","author":"H Lyu","year":"2020","unstructured":"Lyu H, Yoshida K, Zhao SS et al (2020) Delayed denosumab injections and fracture risk among patients with osteoporosis. Ann Intern Med 173(7):516\u2013526. https:\/\/doi.org\/10.7326\/M20-0882","journal-title":"Ann Intern Med"},{"key":"1725_CR8","unstructured":"Bone Health & Osteoporosis Foundation (2023) What is osteoporosis and what causes it? https:\/\/www.bonehealthandosteoporosis.org\/patients\/what-is-osteoporosis\/"},{"issue":"12","key":"1725_CR9","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1016\/j.amjmed.2015.08.011","volume":"128","author":"U Hedegaard","year":"2015","unstructured":"Hedegaard U, Kjeldsen LJ, Potteg\u00e5rd A et al (2015) Improving medication adherence in patients with hypertension: a randomized trial. Am J Med 128(12):1351\u20131361. https:\/\/doi.org\/10.1016\/j.amjmed.2015.08.011","journal-title":"Am J Med"},{"issue":"1","key":"1725_CR10","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s12913-025-12233-7","volume":"25","author":"NB Kutluay","year":"2025","unstructured":"Kutluay NB, Bektay MY, Sumbul-Sekerci B, Sekerci A, Izzettin FV (2025) Impact of clinical pharmacist integration on diabetes management: a prospective cohort. BMC Health Serv Res 25(1):107. https:\/\/doi.org\/10.1186\/s12913-025-12233-7","journal-title":"BMC Health Serv Res"},{"issue":"3","key":"1725_CR11","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s00198-009-0977-z","volume":"21","author":"N Yuksel","year":"2010","unstructured":"Yuksel N, Majumdar SR, Biggs C, Tsuyuki RT (2010) Community pharmacist-initiated screening program for osteoporosis: randomized controlled trial. Osteoporos Int 21(3):391\u2013398. https:\/\/doi.org\/10.1007\/s00198-009-0977-z","journal-title":"Osteoporos Int"},{"issue":"9","key":"1725_CR12","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1177\/1060028018770622","volume":"52","author":"BL Bowers","year":"2018","unstructured":"Bowers BL, Drew AM, Verry C (2018) Impact of pharmacist-physician collaboration on osteoporosis treatment rates. Ann Pharmacother 52(9):876\u2013883. https:\/\/doi.org\/10.1177\/1060028018770622","journal-title":"Ann Pharmacother"},{"issue":"3","key":"1725_CR13","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1345\/aph.1K541","volume":"42","author":"TA Nadrash","year":"2008","unstructured":"Nadrash TA, Plushner SL, Delate T (2008) Clinical pharmacists\u2019 role in improving osteoporosis treatment rates among elderly patients with untreated atraumatic fractures. Ann Pharmacother 42(3):334\u2013340. https:\/\/doi.org\/10.1345\/aph.1K541","journal-title":"Ann Pharmacother"},{"issue":"2","key":"1725_CR14","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1002\/jbmr.3337","volume":"33","author":"SR Cummings","year":"2018","unstructured":"Cummings SR, Ferrari S, Eastell R et al (2018) Vertebral fractures after discontinuation of denosumab: a post hoc analysis of the randomized Placebo-Controlled FREEDOM trial and its extension. J Bone Miner Res 33(2):190\u20138. https:\/\/doi.org\/10.1002\/jbmr.3337","journal-title":"J Bone Miner Res"},{"issue":"9","key":"1725_CR15","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1002\/jbmr.4335","volume":"36","author":"P Burckhardt","year":"2021","unstructured":"Burckhardt P, Faouzi M, Buclin T, Lamy O (2021) Fractures after denosumab discontinuation: a retrospective study of 797 cases. J Bone Miner Res 36(9):1717\u201328. https:\/\/doi.org\/10.1002\/jbmr.4335","journal-title":"J Bone Miner Res"},{"issue":"4","key":"1725_CR16","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1210\/jc.2010-1502","volume":"96","author":"HG Bone","year":"2011","unstructured":"Bone HG, Bolognese MA, Yuen CK, Kendler DL, Miller PD, Yang YC, Grazette L, San Martin J, Gallagher JC (2011) Effects of denosumab treatment and discontinuation on bone mineral density and bone turnover markers in postmenopausal women with low bone mass. J Clin Endocrinol Metab 96(4):972\u2013980","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"1725_CR17","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1210\/jc.2010-1805","volume":"96","author":"PD Miller","year":"2011","unstructured":"Miller PD, Wagman RB, Peacock M, Lewiecki EM, Bolognese MA, Weinstein RL, Ding B, San Martin J, McClung MR (2011) Effect of denosumab on bone mineral density and biochemical markers of bone turnover: six-year results of a phase 2 clinical trial. J Clin Endocrinol Metab 96(2):394\u2013402","journal-title":"J Clin Endocrinol Metab"},{"key":"1725_CR18","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1007\/s00198-021-06234-5","volume":"33","author":"P van den Berg","year":"2022","unstructured":"van den Berg P, Sluiter E, Oosterveld MH, van Leerdam M, Langendijk P, Schweitzer DH (2022) Single pharmacy governed denosumab home administration: optimal adherence by means of a fracture liaison service (FLS) and home care collaboration. Osteoporos Int 33:881\u2013887. https:\/\/doi.org\/10.1007\/s00198-021-06234-5","journal-title":"Osteoporos Int"},{"issue":"2","key":"1725_CR19","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1007\/s00198-023-06933-1","volume":"35","author":"Q Yang","year":"2024","unstructured":"Yang Q, Junhong H, Yuan F (2024) Improvement of proportion of days covered for denosumab under implementation of clinical pharmacist adherence management system: normal and COVID-19 period. Osteoporos Int 35(2):309\u2013316. https:\/\/doi.org\/10.1007\/s00198-023-06933-1","journal-title":"Osteoporos Int"},{"key":"1725_CR20","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1177\/17151635231188334","volume":"156","author":"D Jorgenson","year":"2023","unstructured":"Jorgenson D, Halpape K (2023) Evaluation of a pharmacist-led interprofessional chronic pain clinic in Canada. Can Pharm J (Ott) 156:265\u2013271. https:\/\/doi.org\/10.1177\/17151635231188334","journal-title":"Can Pharm J (Ott)"},{"issue":"11","key":"1725_CR21","doi-asserted-by":"publisher","first-page":"1781","DOI":"10.1345\/aph.1M366","volume":"43","author":"LN Hall","year":"2009","unstructured":"Hall LN, Shrader SP, Ragucci KR (2009) Evaluation of compliance with osteoporosis treatment guidelines after initiation of a pharmacist-run osteoporosis service at a family medicine clinic. Ann Pharmacother 43(11):1781\u20131786. https:\/\/doi.org\/10.1345\/aph.1M366","journal-title":"Ann Pharmacother"},{"issue":"6","key":"1725_CR22","doi-asserted-by":"publisher","first-page":"504","DOI":"10.2146\/ajhp110309","volume":"69","author":"RM Heilmann","year":"2012","unstructured":"Heilmann RM, Friesleben CR, Billups SJ (2012) Impact of a pharmacist-directed intervention in postmenopausal women after fracture. Am J Health Syst Pharm 69(6):504\u2013509. https:\/\/doi.org\/10.2146\/ajhp110309","journal-title":"Am J Health Syst Pharm"},{"issue":"4","key":"1725_CR23","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.24520","volume":"14","author":"T Chowdhury","year":"2022","unstructured":"Chowdhury T, Dutta J, Noel P et al (2022) An overview on causes of nonadherence in the treatment of rheumatoid arthritis: its effect on mortality and ways to improve adherence. Cureus 14(4):e24520. https:\/\/doi.org\/10.7759\/cureus.24520","journal-title":"Cureus"},{"key":"1725_CR24","unstructured":"Joint Guidance on Osteoporosis Management in the ERA of COVID-19 from the ASBMR, AACE, Endocrine Society, ECTS and NOF. https:\/\/www.asbmr.org\/about\/statement-detail\/joint-guidance-on-osteoporosis-management-covid-19."},{"issue":"1","key":"1725_CR25","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s00198-021-06085-0","volume":"33","author":"M Chandran","year":"2022","unstructured":"Chandran M, Hao Y, Kwee AK, Cheen MH, Chin YA, Ng YT (2022) Adherence to dosing schedule of denosumab therapy for osteoporosis during COVID-19 lockdown: an electronic medical record and pharmacy claims database study from Asia. Osteoporos Int 33(1):251\u2013261. https:\/\/doi.org\/10.1007\/s00198-021-06085-0","journal-title":"Osteoporos Int"}],"container-title":["Archives of Osteoporosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11657-026-01725-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11657-026-01725-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11657-026-01725-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T04:22:06Z","timestamp":1785990126000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11657-026-01725-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1725"],"URL":"https:\/\/doi.org\/10.1007\/s11657-026-01725-6","relation":{},"ISSN":["1862-3514"],"issn-type":[{"value":"1862-3514","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"assertion":[{"value":"8 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"None.","order":1,"name":"Ethics","label":"Conflicts of interest","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"114"}}