Pub Date : 2024-10-23DOI: 10.1007/s11657-024-01454-8
A. Weber, T. F. G. Vercoulen, E. Jacobs, A. T. Buizer, S. P. G. Bours, J. P. van den Bergh, R. M. Jeuken, S. M. J. van Kuijk, S. M. A. A. Evers, P. C. Willems
Summary
This nationwide multidisciplinary survey found dissatisfaction among physicians with current osteoporotic vertebral compression fracture care, revealing significant disparities in diagnosis, treatment, and follow-up practices. Issues include poor communication and differing guidelines. Improving interdisciplinary collaboration and standardized care strategies is essential for better patient outcomes.
Purpose
This survey aims to assess current preferred care practices for symptomatic osteoporotic vertebral compression fractures (OVCF) in the Netherlands, focusing on guideline adherence, identifying knowledge gaps, and clarifying consensus and collaboration across medical disciplines in OVCF treatment.
Methods
This cross-sectional study was conducted via Qualtrics (Provo, UT) using a self-administered online survey distributed to 238 general practitioners and physicians in orthopedics, traumatology, internal medicine, rheumatology, and geriatrics working at 51 hospitals in the Netherlands. The survey, conducted in Dutch, included 36 multiple-choice and two open questions and was accessible via an anonymous email link or QR code. General practitioners received additional questions specific to their role. Data was anonymized, stored securely, and analyzed using descriptive statistics in Microsoft Excel and SPSS (Version 24). Open-ended responses were coded and categorized. The survey was conducted prior to the publication of the updated Federation of Medical Specialists guidelines in 2024.
Results
Physicians across various disciplines uniformly expressed dissatisfaction with current OVCF care. The survey highlighted significant disparities in diagnosis, treatment, and follow-up practices. A lack of communication between primary and secondary care providers and differing guidelines further complicate OVCF management. These issues point to considerable variation in clinical practice and gaps in interdisciplinary collaboration.
Conclusion
Addressing the identified issues requires fostering interdisciplinary collaboration and creating cohesive care strategies. Ensuring access to diagnostic resources in both primary and secondary care and establishing coordinated care models promises more structured and standardized treatment. These steps are crucial for enhancing patient outcomes in OVCF management.
{"title":"Disparities in management of symptomatic osteoporotic vertebral compression fractures: a nationwide multidisciplinary survey","authors":"A. Weber, T. F. G. Vercoulen, E. Jacobs, A. T. Buizer, S. P. G. Bours, J. P. van den Bergh, R. M. Jeuken, S. M. J. van Kuijk, S. M. A. A. Evers, P. C. Willems","doi":"10.1007/s11657-024-01454-8","DOIUrl":"10.1007/s11657-024-01454-8","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>This nationwide multidisciplinary survey found dissatisfaction among physicians with current osteoporotic vertebral compression fracture care, revealing significant disparities in diagnosis, treatment, and follow-up practices. Issues include poor communication and differing guidelines. Improving interdisciplinary collaboration and standardized care strategies is essential for better patient outcomes.</p><h3>Purpose</h3><p>This survey aims to assess current preferred care practices for symptomatic osteoporotic vertebral compression fractures (OVCF) in the Netherlands, focusing on guideline adherence, identifying knowledge gaps, and clarifying consensus and collaboration across medical disciplines in OVCF treatment.</p><h3>Methods</h3><p>This cross-sectional study was conducted via Qualtrics (Provo, UT) using a self-administered online survey distributed to 238 general practitioners and physicians in orthopedics, traumatology, internal medicine, rheumatology, and geriatrics working at 51 hospitals in the Netherlands. The survey, conducted in Dutch, included 36 multiple-choice and two open questions and was accessible via an anonymous email link or QR code. General practitioners received additional questions specific to their role. Data was anonymized, stored securely, and analyzed using descriptive statistics in Microsoft Excel and SPSS (Version 24). Open-ended responses were coded and categorized. The survey was conducted prior to the publication of the updated Federation of Medical Specialists guidelines in 2024.</p><h3>Results</h3><p>Physicians across various disciplines uniformly expressed dissatisfaction with current OVCF care. The survey highlighted significant disparities in diagnosis, treatment, and follow-up practices. A lack of communication between primary and secondary care providers and differing guidelines further complicate OVCF management. These issues point to considerable variation in clinical practice and gaps in interdisciplinary collaboration.</p><h3>Conclusion</h3><p>Addressing the identified issues requires fostering interdisciplinary collaboration and creating cohesive care strategies. Ensuring access to diagnostic resources in both primary and secondary care and establishing coordinated care models promises more structured and standardized treatment. These steps are crucial for enhancing patient outcomes in OVCF management.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-23DOI: 10.1007/s11657-024-01458-4
Brit Solvor Lyse Riska, Nina Gunnes, Trine E. Finnes, Haakon E. Meyer, Mari Hoff, Tone K. Omsland, Kristin Holvik
Summary
We aimed to investigate the risk of hip fracture associated with zoledronic acid treatment compared to alendronate on a population level. The risk of hip fracture was lower in women using zoledronic acid and higher in women who had discontinued treatment. The findings support the effectiveness of intravenous bisphosphonate.
Purpose
To investigate whether zoledronic acid (ZOL) was associated with a lower risk of the first hip fracture than alendronate (ALN) in Norway using real-world data.
Methods
Nationwide data on drugs dispensed in outpatient pharmacies were individually linked with all hospital-treated hip fractures. Individuals aged 50–89 years without previous hip fracture were included at their first filling of a prescription for ALN or ZOL during 2005–2016. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) for first hip fracture by time-varying exposure to ZOL versus ALN were estimated in sex-stratified flexible parametric survival analyses. Covariates included time-varying accumulated ALN exposure and comorbidity level expressed by the prescription-based Rx-Risk Comorbidity Index, marital status, education, and residential urbanity.
Results
Of 75,250 women who initiated treatment, 72,614 (96.5%) were exposed to ALN and 6366 (8.5%) to ZOL. Of 12,739 men who initiated treatment, 12,311 (96.6%) were exposed to ALN and 784 (6.2%) to ZOL. In women, the HR for first hip fracture was 0.75 (95% CI: 0.61–0.91) for ZOL versus ALN. In men, the corresponding HR was 0.59 (95% CI: 0.32–1.07). Discontinued treatment was associated with increased risk compared with current ALN treatment in women (HR: 1.33; 95% CI: 1.24–1.42, men: HR 1.13 (95% CI: 0.95–1.35)).
Conclusions
In women, the risk of first hip fracture when treated with ZOL was 25% lower than when treated with ALN. Discontinued treatment was associated with a 33% increase in hip fracture risk. Similar, albeit statistically non-significant, results were observed in men.
{"title":"Risk of first hip fracture under treatment with zoledronic acid versus alendronate: a NOREPOS cohort study of 88,000 Norwegian men and women in outpatient care","authors":"Brit Solvor Lyse Riska, Nina Gunnes, Trine E. Finnes, Haakon E. Meyer, Mari Hoff, Tone K. Omsland, Kristin Holvik","doi":"10.1007/s11657-024-01458-4","DOIUrl":"10.1007/s11657-024-01458-4","url":null,"abstract":"<div><h3>Summary</h3><p>We aimed to investigate the risk of hip fracture associated with zoledronic acid treatment compared to alendronate on a population level. The risk of hip fracture was lower in women using zoledronic acid and higher in women who had discontinued treatment. The findings support the effectiveness of intravenous bisphosphonate.</p><h3>Purpose</h3><p>To investigate whether zoledronic acid (ZOL) was associated with a lower risk of the first hip fracture than alendronate (ALN) in Norway using real-world data.</p><h3>Methods</h3><p>Nationwide data on drugs dispensed in outpatient pharmacies were individually linked with all hospital-treated hip fractures. Individuals aged 50–89 years without previous hip fracture were included at their first filling of a prescription for ALN or ZOL during 2005–2016. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) for first hip fracture by time-varying exposure to ZOL versus ALN were estimated in sex-stratified flexible parametric survival analyses. Covariates included time-varying accumulated ALN exposure and comorbidity level expressed by the prescription-based Rx-Risk Comorbidity Index, marital status, education, and residential urbanity.</p><h3>Results</h3><p>Of 75,250 women who initiated treatment, 72,614 (96.5%) were exposed to ALN and 6366 (8.5%) to ZOL. Of 12,739 men who initiated treatment, 12,311 (96.6%) were exposed to ALN and 784 (6.2%) to ZOL. In women, the HR for first hip fracture was 0.75 (95% CI: 0.61–0.91) for ZOL versus ALN. In men, the corresponding HR was 0.59 (95% CI: 0.32–1.07). Discontinued treatment was associated with increased risk compared with current ALN treatment in women (HR: 1.33; 95% CI: 1.24–1.42, men: HR 1.13 (95% CI: 0.95–1.35)).</p><h3>Conclusions</h3><p>In women, the risk of first hip fracture when treated with ZOL was 25% lower than when treated with ALN. Discontinued treatment was associated with a 33% increase in hip fracture risk. Similar, albeit statistically non-significant, results were observed in men.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-23DOI: 10.1007/s11657-024-01459-3
Dana Alsugeir, Matthew Adesuyan, Christina Avgerinou, Vikram Talaulikar, Li Wei, Ruth Brauer
Summary
In a population-based cohort study of menopausal women with common mental health diagnoses, SSRIs/SNRIs were associated with a 32% increased risk of osteoporotic fractures. The risk of osteoporotic fractures was particularly increased for longer periods of treatment with SSRIs/SNRIs (> 5 years) and in younger menopausal women (< 50 years old).
Purpose
To investigate the association between selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) and the risk of osteoporotic fractures (OF) in menopausal women with common mental health diagnoses (CMHD).
Methods
We conducted the study with two designs (cohort and self-controlled case series [SCCS]), using the IQVIA Medical Research Database (IMRD) UK. The source population comprised women aged ≥ 50 years and women with a record indicating menopause (< 50 years). All women had a recorded CMHD. For the cohort analysis, the risk of OFs was estimated by comparing women prescribed SSRIs/SNRIs (exposed) to those not exposed. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CIs). For the SCCS, women acted as their own controls; periods of exposure to SSRIs/SNRIs were compared to periods of non-exposure using conditional Poisson regression to estimate incidence rate ratios (IRR) with 95% CIs.
Results
We identified 292,848 women, of whom 35,222 experienced OFs within a median follow-up of 6.01 years. We found strong evidence of an association between SSRIs/SNRIs and the risk of OFs (adjusted HR = 1.32, 95% CI:1.29–1.35). Compared to periods of no exposure, SSRIs/SNRIs increased the risk of OFs during the first 30 days (IRR = 1.38, 95% CI:1.26–1.51), during the first 90 days (IRR = 1.58, 95% CI: 1.48–1.69), and the remaining exposure (IRR = 1.42, 95% CI:1.37–1.48).
Conclusions
In a population of menopausal women with CMHDs, the prescribing of SSRIs/SNRIs antidepressants was associated with a higher risk of OFs. Careful assessment of osteoporosis risk needs to be considered when treating menopausal women with SSRIs/SNRIs antidepressants.
{"title":"Risk of osteoporotic fractures in menopausal women with common mental health diagnoses prescribed SSRIs/SNRIs: cohort and self-controlled case series analyses","authors":"Dana Alsugeir, Matthew Adesuyan, Christina Avgerinou, Vikram Talaulikar, Li Wei, Ruth Brauer","doi":"10.1007/s11657-024-01459-3","DOIUrl":"10.1007/s11657-024-01459-3","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>In a population-based cohort study of menopausal women with common mental health diagnoses, SSRIs/SNRIs were associated with a 32% increased risk of osteoporotic fractures. The risk of osteoporotic fractures was particularly increased for longer periods of treatment with SSRIs/SNRIs (> 5 years) and in younger menopausal women (< 50 years old).</p><h3>Purpose</h3><p>To investigate the association between selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) and the risk of osteoporotic fractures (OF) in menopausal women with common mental health diagnoses (CMHD).</p><h3>Methods</h3><p>We conducted the study with two designs (cohort and self-controlled case series [SCCS]), using the IQVIA Medical Research Database (IMRD) UK. The source population comprised women aged ≥ 50 years and women with a record indicating menopause (< 50 years). All women had a recorded CMHD. For the cohort analysis, the risk of OFs was estimated by comparing women prescribed SSRIs/SNRIs (exposed) to those not exposed. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CIs). For the SCCS, women acted as their own controls; periods of exposure to SSRIs/SNRIs were compared to periods of non-exposure using conditional Poisson regression to estimate incidence rate ratios (IRR) with 95% CIs.</p><h3>Results</h3><p>We identified 292,848 women, of whom 35,222 experienced OFs within a median follow-up of 6.01 years. We found strong evidence of an association between SSRIs/SNRIs and the risk of OFs (adjusted HR = 1.32, 95% CI:1.29–1.35). Compared to periods of no exposure, SSRIs/SNRIs increased the risk of OFs during the first 30 days (IRR = 1.38, 95% CI:1.26–1.51), during the first 90 days (IRR = 1.58, 95% CI: 1.48–1.69), and the remaining exposure (IRR = 1.42, 95% CI:1.37–1.48).</p><h3>Conclusions</h3><p>In a population of menopausal women with CMHDs, the prescribing of SSRIs/SNRIs antidepressants was associated with a higher risk of OFs. Careful assessment of osteoporosis risk needs to be considered when treating menopausal women with SSRIs/SNRIs antidepressants.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-22DOI: 10.1007/s11657-024-01451-x
Stefano Carugo, Fabio Vescini, Andrea Giusti, Giulia Letizia Mauro, Laura Tafaro, Francescaromana Festuccia, Lucia Muraca, Paolo Menè, Maurizio Rossini
Summary
An Italian multidisciplinary working group discussed the current Italian scenario of osteoporosis management during a meeting and highlighted the essential role of calcium and vitamin D supplementation in the prevention of fragility fractures.
Purpose
This paper aims to review and discuss data on calcium and vitamin D requirements and the role of combined calcium and vitamin D supplementation in the treatment of patients with osteoporosis.
Methods
The discussion of the experts covered literature data on calcium and vitamin D supplementation, gaps in the diagnosis and treatment of osteoporosis, and the role of the primary care physician in identifying and treating patients with osteoporosis. Articles for consideration were identified through PubMed searches using different combinations of pertinent keywords.
Results
The discussion highlighted that insufficient calcium or vitamin D intake increases the risk of fragility fractures. The experts also drew attention to the essential role of calcium and vitamin D supplementation in achieving an anti-fracture effect and supporting the efficacy of anti-osteoporotic agents without increasing nephrolithiasis and cardiovascular risks. In addition, the discussion underlined the role of the primary care physician in the initial clinical approach to patients with osteoporosis.
Conclusions
The experts believe that efficient treatment for patients with osteoporosis should include calcium and vitamin D supplementation to achieve adequate levels that are able to inhibit the parathyroid hormone and bone resorption.
一个意大利多学科工作组在一次会议上讨论了意大利目前的骨质疏松症治疗情况，并强调了钙和维生素 D 补充剂在预防脆性骨折中的重要作用。目的：本文旨在回顾和讨论有关钙和维生素 D 需求量的数据，以及钙和维生素 D 联合补充剂在骨质疏松症患者治疗中的作用：专家们的讨论涉及钙和维生素 D 补充的文献数据、骨质疏松症诊断和治疗方面的差距以及初级保健医生在识别和治疗骨质疏松症患者中的作用。通过使用不同的相关关键词组合在 PubMed 上进行搜索，确定了供审议的文章：讨论强调，钙或维生素 D 摄入不足会增加脆性骨折的风险。专家们还提请注意，钙和维生素 D 补充剂在实现抗骨折效果和支持抗骨质疏松药物疗效方面发挥着重要作用，同时不会增加肾炎和心血管风险。此外，讨论还强调了初级保健医生在骨质疏松症患者初期临床治疗中的作用：专家们认为，骨质疏松症患者的有效治疗应包括补充钙和维生素 D，以达到能够抑制甲状旁腺激素和骨吸收的适当水平。
{"title":"The essential role of combined calcium and vitamin D supplementation in the osteoporosis scenario in italy: Expert opinion paper","authors":"Stefano Carugo, Fabio Vescini, Andrea Giusti, Giulia Letizia Mauro, Laura Tafaro, Francescaromana Festuccia, Lucia Muraca, Paolo Menè, Maurizio Rossini","doi":"10.1007/s11657-024-01451-x","DOIUrl":"10.1007/s11657-024-01451-x","url":null,"abstract":"<div><h3>Summary</h3><p>An Italian multidisciplinary working group discussed the current Italian scenario of osteoporosis management during a meeting and highlighted the essential role of calcium and vitamin D supplementation in the prevention of fragility fractures.</p><h3>Purpose</h3><p>This paper aims to review and discuss data on calcium and vitamin D requirements and the role of combined calcium and vitamin D supplementation in the treatment of patients with osteoporosis.</p><h3>Methods</h3><p>The discussion of the experts covered literature data on calcium and vitamin D supplementation, gaps in the diagnosis and treatment of osteoporosis, and the role of the primary care physician in identifying and treating patients with osteoporosis. Articles for consideration were identified through PubMed searches using different combinations of pertinent keywords.</p><h3>Results</h3><p>The discussion highlighted that insufficient calcium or vitamin D intake increases the risk of fragility fractures. The experts also drew attention to the essential role of calcium and vitamin D supplementation in achieving an anti-fracture effect and supporting the efficacy of anti-osteoporotic agents without increasing nephrolithiasis and cardiovascular risks. In addition, the discussion underlined the role of the primary care physician in the initial clinical approach to patients with osteoporosis.</p><h3>Conclusions</h3><p>The experts believe that efficient treatment for patients with osteoporosis should include calcium and vitamin D supplementation to achieve adequate levels that are able to inhibit the parathyroid hormone and bone resorption.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-17DOI: 10.1007/s11657-024-01455-7
Jing Pan, Peng-cheng Lin, Shen-chu Gong, Ze Wang, Rui Cao, Yuan Lv, Kun Zhang, Lin Wang
Summary
A multi-feature fusion DCNN model for automated evaluation of lumbar vertebrae L1 on chest combined with clinical information and radiomics permits estimation of volumetric bone mineral density for evaluation of osteoporosis.
Purpose
To develop a multi-feature deep learning model based on chest CT, combined with clinical information and radiomics to explore the feasibility in screening for osteoporosis based on estimation of volumetric bone mineral density.
Methods
The chest CT images of 1048 health check subjects were retrospectively collected as the master dataset, and the images of 637 subjects obtained from a different CT scanner were used for the external validation cohort. The subjects were divided into three categories according to the quantitative CT (QCT) examination, namely, normal group, osteopenia group, and osteoporosis group. Firstly, a deep learning–based segmentation model was constructed. Then, classification models were established and selected, and then, an optimal model to build bone density value prediction regression model was chosen.
Results
The DSC value was 0.951 ± 0.030 in the testing dataset and 0.947 ± 0.060 in the external validation cohort. The multi-feature fusion model based on the lumbar 1 vertebra had the best performance in the diagnosis. The area under the curve (AUC) of diagnosing normal, osteopenia, and osteoporosis was 0.992, 0.973, and 0.989. The mean absolute errors (MAEs) of the bone density prediction regression model in the test set and external testing dataset are 8.20 mg/cm3 and 9.23 mg/cm3, respectively, and the root mean square errors (RMSEs) are 10.25 mg/cm3 and 11.91 mg/cm3, respectively. The R-squared values are 0.942 and 0.923, respectively. The Pearson correlation coefficients are 0.972 and 0.965.
Conclusion
The multi-feature fusion DCNN model based on only the lumbar 1 vertebrae and clinical variables can perform bone density three-classification diagnosis and estimate volumetric bone mineral density. If confirmed in independent populations, this automated opportunistic chest CT evaluation can help clinical screening of large-sample populations to identify subjects at high risk of osteoporotic fracture.
{"title":"Feasibility study of opportunistic osteoporosis screening on chest CT using a multi-feature fusion DCNN model","authors":"Jing Pan, Peng-cheng Lin, Shen-chu Gong, Ze Wang, Rui Cao, Yuan Lv, Kun Zhang, Lin Wang","doi":"10.1007/s11657-024-01455-7","DOIUrl":"10.1007/s11657-024-01455-7","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>A multi-feature fusion DCNN model for automated evaluation of lumbar vertebrae L1 on chest combined with clinical information and radiomics permits estimation of volumetric bone mineral density for evaluation of osteoporosis.</p><h3>Purpose</h3><p>To develop a multi-feature deep learning model based on chest CT, combined with clinical information and radiomics to explore the feasibility in screening for osteoporosis based on estimation of volumetric bone mineral density.</p><h3>Methods</h3><p>The chest CT images of 1048 health check subjects were retrospectively collected as the master dataset, and the images of 637 subjects obtained from a different CT scanner were used for the external validation cohort. The subjects were divided into three categories according to the quantitative CT (QCT) examination, namely, normal group, osteopenia group, and osteoporosis group. Firstly, a deep learning–based segmentation model was constructed. Then, classification models were established and selected, and then, an optimal model to build bone density value prediction regression model was chosen.</p><h3>Results</h3><p>The DSC value was 0.951 ± 0.030 in the testing dataset and 0.947 ± 0.060 in the external validation cohort. The multi-feature fusion model based on the lumbar 1 vertebra had the best performance in the diagnosis. The area under the curve (AUC) of diagnosing normal, osteopenia, and osteoporosis was 0.992, 0.973, and 0.989. The mean absolute errors (MAEs) of the bone density prediction regression model in the test set and external testing dataset are 8.20 mg/cm<sup>3</sup> and 9.23 mg/cm<sup>3</sup>, respectively, and the root mean square errors (RMSEs) are 10.25 mg/cm<sup>3</sup> and 11.91 mg/cm<sup>3</sup>, respectively. The <i>R</i>-squared values are 0.942 and 0.923, respectively. The Pearson correlation coefficients are 0.972 and 0.965.</p><h3>Conclusion</h3><p>The multi-feature fusion DCNN model based on only the lumbar 1 vertebrae and clinical variables can perform bone density three-classification diagnosis and estimate volumetric bone mineral density. If confirmed in independent populations, this automated opportunistic chest CT evaluation can help clinical screening of large-sample populations to identify subjects at high risk of osteoporotic fracture.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-024-01455-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brief rationale: Zoledronic acid treatment against osteoporosis is limited by APR. Main result: Combination therapy (hydrocortisone plus non-steroidal anti-inflammatory drugs, acetaminophen, and prednisolone) reduced intolerable APR levels and provided complete symptom relief in most patients. Significance of the paper: Combination therapy can enhance patient outcomes in osteoporosis management.
Purpose
Osteoporosis is a common condition associated with high morbidity rates, often requiring treatment with bisphosphonates such as zoledronic acid. However, the persistence to zoledronic acid infusion is commonly limited by acute phase response (APR). This retrospective study aimed to evaluate the efficacy of a novel combination therapy in preventing APR symptoms.
Methods
A retrospective case–control study was conducted on 931 patients who received their first zoledronic acid infusion between 2011 and 2021. We evaluated the efficacy of combination therapy comprising a single dose of hydrocortisone prior to the infusion and a 3-d oral regimen of non-steroidal anti-inflammatory drugs, acetaminophen, and prednisolone following the infusion. Patients were divided into protocol (receiving combination therapy) and control groups (without treatment). Baseline characteristics, APR incidence, and the efficacy of symptom control were compared between groups using Fisher’s exact test and Student’s t-test.
Results
There was no difference in APR incidence between the protocol (n = 507) and control group (n = 407; p = 0.1442). However, the protocol group exhibited lower intolerable APR levels (3.72% vs. 16.71%; p < 0.0001) and complete symptom relief in 96.28% of cases.
Conclusion
The combination therapy protocol effectively reduced intolerable APR and relieved symptoms in most patients following zoledronic acid infusion. This study highlights the importance of proactive management strategies for APR and emphasizes the potential of combination therapy in alleviating APR symptoms and reducing the occurrence of severe APR in patients undergoing osteoporosis management.
{"title":"Novel combined pharmacological strategy to alleviate acute phase response following zoledronic acid treatment","authors":"Chung-Hwan Chen, En Kee Yeap, Chia-Hao Hsu, Yen-Mou Lu, Tsung-Lin Cheng, Tien-Ching Lee, Cheng-Jung Ho, Jhong-You Li, Hsin-Yi Shen, Hsuan-Ti Huang, Cheng-Chang Lu, Sung-Yen Lin","doi":"10.1007/s11657-024-01452-w","DOIUrl":"10.1007/s11657-024-01452-w","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p><b>Brief rationale:</b> Zoledronic acid treatment against osteoporosis is limited by APR. <b>Main result:</b> Combination therapy (hydrocortisone plus non-steroidal anti-inflammatory drugs, acetaminophen, and prednisolone) reduced intolerable APR levels and provided complete symptom relief in most patients. <b>Significance of the paper:</b> Combination therapy can enhance patient outcomes in osteoporosis management.</p><h3>Purpose</h3><p>Osteoporosis is a common condition associated with high morbidity rates, often requiring treatment with bisphosphonates such as zoledronic acid. However, the persistence to zoledronic acid infusion is commonly limited by acute phase response (APR). This retrospective study aimed to evaluate the efficacy of a novel combination therapy in preventing APR symptoms.</p><h3>Methods</h3><p>A retrospective case–control study was conducted on 931 patients who received their first zoledronic acid infusion between 2011 and 2021. We evaluated the efficacy of combination therapy comprising a single dose of hydrocortisone prior to the infusion and a 3-d oral regimen of non-steroidal anti-inflammatory drugs, acetaminophen, and prednisolone following the infusion. Patients were divided into protocol (receiving combination therapy) and control groups (without treatment). Baseline characteristics, APR incidence, and the efficacy of symptom control were compared between groups using Fisher’s exact test and Student’s <i>t</i>-test.</p><h3>Results</h3><p>There was no difference in APR incidence between the protocol (<i>n</i> = 507) and control group (<i>n</i> = 407; <i>p</i> = 0.1442). However, the protocol group exhibited lower intolerable APR levels (3.72% vs. 16.71%; <i>p</i> < 0.0001) and complete symptom relief in 96.28% of cases.</p><h3>Conclusion</h3><p>The combination therapy protocol effectively reduced intolerable APR and relieved symptoms in most patients following zoledronic acid infusion. This study highlights the importance of proactive management strategies for APR and emphasizes the potential of combination therapy in alleviating APR symptoms and reducing the occurrence of severe APR in patients undergoing osteoporosis management.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-024-01452-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-10DOI: 10.1007/s11657-024-01453-9
Frank Malgo, Floor J. A. van Deudekom, Roos Hup, Henk A. Formijne Jonkers, Diederik H. R. Kempen, Kerst de Vries, Hanna C. Willems, Annegreet G. Vlug
Summary
Administering zoledronic acid (ZA) to older hip fracture patients during the hospital stay has faced safety concerns. However, in this study of 161 patients, no ZA-related side effects or readmissions were observed, demonstrating that ZA administration during hospitalization is safe and effective for secondary fracture prevention.
Purpose
According to the 2022 Dutch ‘Osteoporosis and fracture prevention’ guideline, zoledronic acid (ZA) is the preferred osteoporosis treatment for hip fracture patients. Less than 25% of hip fracture patients visit the outpatient fracture liaison service, therefore inpatient administration of ZA during the hip fracture hospitalization is now recommended in patients > 75 years. In the OLVG Hospital, inpatient administration of ZA during hospitalization for hip fracture in older patients has been standard of care since 2020.
Methods
This single center retrospective observational follow-up study included hip fracture patients > 75 years admitted to the orthogeriatric ward of the OLVG Hospital, and treated with 5 mg of ZA intravenously on the day of hospital discharge between June 2020 and December 2022. Life expectancy estimated < 12 months, creatinine clearance < 35 ml/min, hypocalcemia, and high risk of osteonecrosis of the jaw were contra-indications. During three months of follow-up (FU) adverse events, emergency room visits, hospital readmissions, and death were recorded.
Results
In 161 consecutive hospitalized hip fracture patients (mean age 86 ± 6 years, 65% female, 18% nursing home) ZA was administered and no adverse events were recorded. During 3 months of FU, 8 patients (5%) visited the emergency room, 19 patients (12%) were re-admitted to the hospital, 3 with a new fracture (2 contralateral hip, 1 radius), and 17 patients (11%) died of reasons unrelated to ZA.
Conclusion
This study shows that inpatient administration of zoledronic acid during hip fracture hospitalization is safe and feasible to prevent future fragility fractures in older hip fracture patients.
{"title":"Inpatient zoledronic acid in older hip fracture patients is well tolerated and safe","authors":"Frank Malgo, Floor J. A. van Deudekom, Roos Hup, Henk A. Formijne Jonkers, Diederik H. R. Kempen, Kerst de Vries, Hanna C. Willems, Annegreet G. Vlug","doi":"10.1007/s11657-024-01453-9","DOIUrl":"10.1007/s11657-024-01453-9","url":null,"abstract":"<div><h3>Summary</h3><p>Administering zoledronic acid (ZA) to older hip fracture patients during the hospital stay has faced safety concerns. However, in this study of 161 patients, no ZA-related side effects or readmissions were observed, demonstrating that ZA administration during hospitalization is safe and effective for secondary fracture prevention.</p><h3>Purpose</h3><p>According to the 2022 Dutch ‘Osteoporosis and fracture prevention’ guideline, zoledronic acid (ZA) is the preferred osteoporosis treatment for hip fracture patients. Less than 25% of hip fracture patients visit the outpatient fracture liaison service, therefore inpatient administration of ZA during the hip fracture hospitalization is now recommended in patients > 75 years. In the OLVG Hospital, inpatient administration of ZA during hospitalization for hip fracture in older patients has been standard of care since 2020.</p><h3>Methods</h3><p>This single center retrospective observational follow-up study included hip fracture patients > 75 years admitted to the orthogeriatric ward of the OLVG Hospital, and treated with 5 mg of ZA intravenously on the day of hospital discharge between June 2020 and December 2022. Life expectancy estimated < 12 months, creatinine clearance < 35 ml/min, hypocalcemia, and high risk of osteonecrosis of the jaw were contra-indications. During three months of follow-up (FU) adverse events, emergency room visits, hospital readmissions, and death were recorded.</p><h3>Results</h3><p>In 161 consecutive hospitalized hip fracture patients (mean age 86 ± 6 years, 65% female, 18% nursing home) ZA was administered and no adverse events were recorded. During 3 months of FU, 8 patients (5%) visited the emergency room, 19 patients (12%) were re-admitted to the hospital, 3 with a new fracture (2 contralateral hip, 1 radius), and 17 patients (11%) died of reasons unrelated to ZA.</p><h3>Conclusion</h3><p>This study shows that inpatient administration of zoledronic acid during hip fracture hospitalization is safe and feasible to prevent future fragility fractures in older hip fracture patients.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-08DOI: 10.1007/s11657-024-01456-6
Changming Xiao, Haozhong Wang, Yang Lei, Haoping Dai, Kaiquan Zhang, Mingzhong Xie, Sen Li
<div><h3> <i>Summary</i> </h3><p>A retrospective comparative study revealed that percutaneous kyphoplasty combined with pediculoplasty (PKCPP) offers more benefits in terms of pain relief, spinal stability, and complications compared to simple percutaneous kyphoplasty. Moreover, PKCPP can augment and internally fixate the severe osteoporotic vertebral fractures.</p><h3>Purpose</h3><p>Vertebral augmentation (VA) has emerged as a satisfactory and minimally invasive surgical approach for severe osteoporotic vertebral fractures (OVFs). However, treating severe OVFs with advanced collapse, burst morphology with MC injury, posterior wall retropulsion, high degree of osseous fragmentation, pediculo-somatic junction fracture, and large vacuum cleft presents significant challenges. This study aimed to evaluate the effectiveness of percutaneous kyphoplasty combined with pediculoplasty (PKCPP) in reducing refracture, preventing further collapse and bone cement displacement, reconstructing vertebral body (VB) stability, and providing internal fixation of the anterior column (AC), middle column (MC), and the bilateral pedicles.</p><h3>Methods</h3><p>The current study was designed as a retrospective review of clinical and radiologic parameters. From July 2018 to September 2021, ninety-six patients with severe OVFs and without neurological deficit were treated either with simple percutaneous kyphoplasty (simple PKP group, <i>n</i> = 54) or with percutaneous kyphoplasty combined with pediculoplasty (PKCPP group, <i>n</i> = 42). All patients were followed up for at least 1 year, and clinical and radiological outcomes were assessed. Surgery duration and bone cement volume were compared between the two groups, as well as analgesic dosage and hospital stay. Anterior wall height (AWH), posterior wall height (PWH), and Cobb angle (CA) were measured and analyzed before and after surgery.</p><h3>Results</h3><p>The simple PKP group had significantly shorter surgery duration and lower bone cement volume compared to the PKCPP group (<i>P</i> < 0.05). Conversely, the simple PKP group had significantly higher analgesic dosage and longer hospital stay than the PKCPP group (<i>P</i> < 0.05). Both groups showed significant improvements in AWH, PWH, and CA after surgery (<i>P</i> < 0.05). At the final follow-up, the PWH in the simple PKP group was significantly lower than the preoperative measurement (<i>P</i> < 0.05), and the difference in PWH between the two groups was statistically significant (<i>P</i> > 0.05). Moreover, both groups demonstrated a significant reduction in CA after surgery, with the PKCPP group showing a greater reduction compared to the simple PKP group throughout the postoperative period to the final follow-up (<i>P</i> < 0.05). VAS and ODI scores significantly decreased in both groups after surgery (<i>P</i> < 0.05), with no significant difference between the groups at the final follow
{"title":"Percutaneous kyphoplasty combined with pediculoplasty (PKCPP) augments and internally fixates the severe osteoporotic vertebral fractures: a retrospective comparative study","authors":"Changming Xiao, Haozhong Wang, Yang Lei, Haoping Dai, Kaiquan Zhang, Mingzhong Xie, Sen Li","doi":"10.1007/s11657-024-01456-6","DOIUrl":"10.1007/s11657-024-01456-6","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>A retrospective comparative study revealed that percutaneous kyphoplasty combined with pediculoplasty (PKCPP) offers more benefits in terms of pain relief, spinal stability, and complications compared to simple percutaneous kyphoplasty. Moreover, PKCPP can augment and internally fixate the severe osteoporotic vertebral fractures.</p><h3>Purpose</h3><p>Vertebral augmentation (VA) has emerged as a satisfactory and minimally invasive surgical approach for severe osteoporotic vertebral fractures (OVFs). However, treating severe OVFs with advanced collapse, burst morphology with MC injury, posterior wall retropulsion, high degree of osseous fragmentation, pediculo-somatic junction fracture, and large vacuum cleft presents significant challenges. This study aimed to evaluate the effectiveness of percutaneous kyphoplasty combined with pediculoplasty (PKCPP) in reducing refracture, preventing further collapse and bone cement displacement, reconstructing vertebral body (VB) stability, and providing internal fixation of the anterior column (AC), middle column (MC), and the bilateral pedicles.</p><h3>Methods</h3><p>The current study was designed as a retrospective review of clinical and radiologic parameters. From July 2018 to September 2021, ninety-six patients with severe OVFs and without neurological deficit were treated either with simple percutaneous kyphoplasty (simple PKP group, <i>n</i> = 54) or with percutaneous kyphoplasty combined with pediculoplasty (PKCPP group, <i>n</i> = 42). All patients were followed up for at least 1 year, and clinical and radiological outcomes were assessed. Surgery duration and bone cement volume were compared between the two groups, as well as analgesic dosage and hospital stay. Anterior wall height (AWH), posterior wall height (PWH), and Cobb angle (CA) were measured and analyzed before and after surgery.</p><h3>Results</h3><p>The simple PKP group had significantly shorter surgery duration and lower bone cement volume compared to the PKCPP group (<i>P</i> < 0.05). Conversely, the simple PKP group had significantly higher analgesic dosage and longer hospital stay than the PKCPP group (<i>P</i> < 0.05). Both groups showed significant improvements in AWH, PWH, and CA after surgery (<i>P</i> < 0.05). At the final follow-up, the PWH in the simple PKP group was significantly lower than the preoperative measurement (<i>P</i> < 0.05), and the difference in PWH between the two groups was statistically significant (<i>P</i> > 0.05). Moreover, both groups demonstrated a significant reduction in CA after surgery, with the PKCPP group showing a greater reduction compared to the simple PKP group throughout the postoperative period to the final follow-up (<i>P</i> < 0.05). VAS and ODI scores significantly decreased in both groups after surgery (<i>P</i> < 0.05), with no significant difference between the groups at the final follow","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-04DOI: 10.1007/s11657-024-01450-y
Rimesh Pal, Trupti N. Prasad, Sanjay K. Bhadada, Veenu Singla, Urmila Yadav, Nipun Chawla
Summary
Bone microarchitecture, as assessed using high-resolution peripheral quantitative computed tomography, is adversely affected in postmenopausal women with type 2 diabetes mellitus having sarcopenia/sarcopenic obesity while areal bone mineral density does not differ between those with and without sarcopenia.
Purpose
Type 2 diabetes (T2D) increases the risk of sarcopenia, which independently contributes to bone fragility. We aimed to explore the association between sarcopenia/sarcopenic obesity and bone quality using second-generation high-resolution peripheral quantitative computed tomography (HR-pQCT) in T2D.
Methods
We analyzed the baseline participant characteristics of an ongoing randomized clinical pilot trial (CTRI/2022/02/039978). Postmenopausal women (≥ 50 years) with T2D and high risk of fragility fractures were included. Areal BMD (aBMD), trabecular bone score (TBS), and body composition were measured using DXA. Bone microarchitecture was assessed at distal radius/distal tibia using HR-pQCT. Muscle strength was estimated using dominant handgrip strength (HGS). Sarcopenia was defined as low HGS (< 18.0 kg) and low appendicular skeletal muscle index (ASMI) (< 4.61 kg/m2). Probable sarcopenia was defined as low HGS with normal ASMI. Sarcopenic obesity was classified as co-existence of sarcopenia and obesity (BMI ≥ 25.0 kg/m2).
Results
We recruited 129 postmenopausal women (mean age 64.2 ± 6.7 years). Participants were categorized into four mutually exclusive groups: group A (normal HGS and ASMI, n = 17), group B (probable sarcopenia, n = 77), group C (non-obese sarcopenia, n = 18), and group D (obese sarcopenia, n = 18). The four groups did not differ significantly with regard to baseline characteristics, fracture prevalence, HbA1c, aBMD, and TBS. However, HR-pQCT-derived volumetric BMD and cortical/trabecular microarchitecture were significantly poorer in group C/group D than in group A/group B.
Conclusions
Bone quality rather than bone density (quantity) is adversely affected in T2D postmenopausal women with sarcopenia/sarcopenic obesity, which could increase the fracture risk in this patient sub-population.
{"title":"Association between bone microarchitecture and sarcopenia in postmenopausal women with type 2 diabetes","authors":"Rimesh Pal, Trupti N. Prasad, Sanjay K. Bhadada, Veenu Singla, Urmila Yadav, Nipun Chawla","doi":"10.1007/s11657-024-01450-y","DOIUrl":"10.1007/s11657-024-01450-y","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Bone microarchitecture, as assessed using high-resolution peripheral quantitative computed tomography, is adversely affected in postmenopausal women with type 2 diabetes mellitus having sarcopenia/sarcopenic obesity while areal bone mineral density does not differ between those with and without sarcopenia.</p><h3>Purpose</h3><p>Type 2 diabetes (T2D) increases the risk of sarcopenia, which independently contributes to bone fragility. We aimed to explore the association between sarcopenia/sarcopenic obesity and bone quality using second-generation high-resolution peripheral quantitative computed tomography (HR-pQCT) in T2D.</p><h3>Methods</h3><p>We analyzed the baseline participant characteristics of an ongoing randomized clinical pilot trial (CTRI/2022/02/039978). Postmenopausal women (≥ 50 years) with T2D and high risk of fragility fractures were included. Areal BMD (aBMD), trabecular bone score (TBS), and body composition were measured using DXA. Bone microarchitecture was assessed at distal radius/distal tibia using HR-pQCT. Muscle strength was estimated using dominant handgrip strength (HGS). <i>Sarcopenia</i> was defined as low HGS (< 18.0 kg) and low appendicular skeletal muscle index (ASMI) (< 4.61 kg/m<sup>2</sup>). <i>Probable sarcopenia</i> was defined as low HGS with normal ASMI. <i>Sarcopenic obesity</i> was classified as co-existence of sarcopenia and obesity (BMI ≥ 25.0 kg/m<sup>2</sup>).</p><h3>Results</h3><p>We recruited 129 postmenopausal women (mean age 64.2 ± 6.7 years). Participants were categorized into four mutually exclusive groups: group A (normal HGS and ASMI, <i>n</i> = 17), group B (probable sarcopenia, <i>n</i> = 77), group C (non-obese sarcopenia, <i>n</i> = 18), and group D (obese sarcopenia, <i>n</i> = 18). The four groups did not differ significantly with regard to baseline characteristics, fracture prevalence, HbA1c, aBMD, and TBS. However, HR-pQCT-derived volumetric BMD and cortical/trabecular microarchitecture were significantly poorer in group C/group D than in group A/group B.</p><h3>Conclusions</h3><p>Bone quality rather than bone density (quantity) is adversely affected in T2D postmenopausal women with sarcopenia/sarcopenic obesity, which could increase the fracture risk in this patient sub-population.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1007/s11657-024-01449-5
Joanna E. M. Sale, Suvabna Theivendrampillai, Denise Linton, Judy Porteous
Summary
Most participants reported a positive perception of bone active medication despite sustaining a fracture while taking the medication, reporting medication side effects, or having a healthcare provider stop the prescription. Participants did not appear to connect the medication to fracture risk, suggesting this connection should be emphasized by healthcare providers.
Objective
Our purpose was to examine perceptions about bone active medication from individuals with a fragility fracture and a prescription for bone active medication.
Methods
In this qualitative description study, eligible participants were those who attended an Osteoporosis Canada education session, and reported sustaining a previous fragility fracture and receiving a prescription for bone active medication. We conducted one-on-one interviews and analyzed the data using the analytic hierarchy approach.
Results
We interviewed 32 female participants (age range 58–89 years). Based on our analysis, two themes were developed: (1) most participants spoke positively about bone active medication, indicating they were willing to start, or continue to take, their medication. Positive perceptions were held by participants who sustained a fracture while taking bone active medication, participants whose healthcare provider had stopped the prescription, and participants who reported side effects from the medication; (2) most participants did not discuss bone active medication in relation to their fracture and did not appear to connect the medication to the concept of fracture risk. Instead, participants talked about the medication in relation to bone health in general, or to bone density.
Conclusion
Participants appeared to have positive perceptions of bone active medication, despite sustaining a fracture while taking the medication, reporting medication side effects, or having a healthcare provider stop the prescription. Participants did not connect bone active medication to the concept of fracture risk, illustrating the need for healthcare providers to emphasize the connection between fracture risk and bone active medication.
{"title":"Individuals with a fragility fracture and a prescription for bone active medication have a positive perception of the medication but do not associate it with fracture risk reduction","authors":"Joanna E. M. Sale, Suvabna Theivendrampillai, Denise Linton, Judy Porteous","doi":"10.1007/s11657-024-01449-5","DOIUrl":"10.1007/s11657-024-01449-5","url":null,"abstract":"<div><h3>Summary</h3><p>Most participants reported a positive perception of bone active medication despite sustaining a fracture while taking the medication, reporting medication side effects, or having a healthcare provider stop the prescription. Participants did not appear to connect the medication to fracture risk, suggesting this connection should be emphasized by healthcare providers.</p><h3>Objective</h3><p>Our purpose was to examine perceptions about bone active medication from individuals with a fragility fracture and a prescription for bone active medication.</p><h3>Methods</h3><p>In this qualitative description study, eligible participants were those who attended an Osteoporosis Canada education session, and reported sustaining a previous fragility fracture and receiving a prescription for bone active medication. We conducted one-on-one interviews and analyzed the data using the analytic hierarchy approach.</p><h3>Results</h3><p>We interviewed 32 female participants (age range 58–89 years). Based on our analysis, two themes were developed: (1) most participants spoke positively about bone active medication, indicating they were willing to start, or continue to take, their medication. Positive perceptions were held by participants who sustained a fracture while taking bone active medication, participants whose healthcare provider had stopped the prescription, and participants who reported side effects from the medication; (2) most participants did not discuss bone active medication in relation to their fracture and did not appear to connect the medication to the concept of fracture risk. Instead, participants talked about the medication in relation to bone health in general, or to bone density.</p><h3>Conclusion</h3><p>Participants appeared to have positive perceptions of bone active medication, despite sustaining a fracture while taking the medication, reporting medication side effects, or having a healthcare provider stop the prescription. Participants did not connect bone active medication to the concept of fracture risk, illustrating the need for healthcare providers to emphasize the connection between fracture risk and bone active medication.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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