Acceptability of screening to prevent osteoporotic fractures: a qualitative study with older women

Emmett, Clare L.; Redmond, Niamh M; Peters, Tim J.; Clarke, Shane; Shepstone, Lee; Lenaghan, Elizabeth; Shaw, Alison

doi:10.1093/fampra/cmr069

Cited by 15 publications

(19 citation statements)

References 17 publications

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“…Generally positive attitudes respecting prevention were expressed regarding screening among older women and general practitioners in the UK [63]. Overall, screening did not substantially affect anxiety or activity engagement.…”

Section: Resultsmentioning

confidence: 99%

“…Main concerns revolved around targeting and cost-effectiveness. Location of scans, fears of the magnetic resonant imaging machine, and costs of the scans were all raised as issues for implementation [63]. Regarding nutrition, Dutch healthcare professionals' perceived barriers to implementing a nutritional intervention for older adult hip fracture patients have been explored [64].…”

Section: Resultsmentioning

confidence: 99%

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Qualitative Insights from the Osteoporosis Research: A Narrative Review of the Literature

Bombak

Hanson

2016

Journal of Osteoporosis

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Purpose. Much of the research on osteoporosis has been generated quantitatively. However, the qualitative osteoporosis literature provides valuable information on patient and clinician experiences and perspectives, informing the design and implementation of health research and healthcare services. To identify knowledge gaps and inform the design of future qualitative research, a narrative review was conducted to consolidate and synthesize the existing insights available within the qualitative osteoporosis research. Methods. Search terms reflecting the domains of osteoporosis and qualitative research were entered into the Scopus database to generate a comprehensive survey of qualitative research in the area of osteoporosis. Articles were thematically analysed and the results are presented in the form of a narrative review. Results. Forty-four articles were included in the narrative review. Qualitative research in the field of osteoporosis research can be summarized by 3 thematic areas: the meaning of osteoporosis for patients and the public, the lived experience of an osteoporosis diagnosis, and the programmatic approach to osteoporosis prevention and treatment. Conclusions. Qualitative studies provide clinically valuable insights in how osteoporosis is conceptualized and managed and programmatic aspects of osteoporosis treatment. The findings of this narrative review suggest the need for balance between presenting osteoporosis as a serious health condition and producing unwarranted anxiety and inactivity so as to ensure the best possible outcomes for individuals with osteoporosis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Qualitative Insights from the Osteoporosis Research: A Narrative Review of the Literature

Bombak

Hanson

2016

Journal of Osteoporosis

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“…The approach appears to be acceptable to both patients and GPs. (13) During 5 years of follow-up, prescriptions for antiosteoporosis medications were more frequent, and hip fracture incidence lower, in the screening intervention arm compared with the control arm (Table 1). Anti-osteoporosis medications were particularly frequently prescribed in those intervention participants classified as high fracture risk, and so we hypothesized that the effect of screening to reduce hip fractures would be greatest in women with higher baseline FRAX probability, with a consequent interaction between baseline FRAX hip fracture probability and screening effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Management of Patients With High Baseline Hip Fracture Risk by FRAX Reduces Hip Fractures—A Post Hoc Analysis of the SCOOP Study

McCloskey

Johansson

Harvey

et al. 2018

Journal of Bone and Mineral Research

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The Screening for Osteoporosis in Older Women for the Prevention of Fracture (SCOOP) study was a community-based screening intervention in women aged 70 to 85 years in the United Kingdom. In the screening arm, licensed osteoporosis treatments were recommended in women identified to be at high risk of hip fracture using the FRAX risk assessment tool (including bone mineral density measurement). In the control arm, standard care was provided. Screening led to a 28% reduction in hip fractures over 5 years. In this planned post hoc analysis, we wished to examine for interactions between screening effectiveness on fracture outcome (any, osteoporotic, and hip fractures) on the one hand and baseline FRAX 10-year probability of hip fracture on the other. All analyses were conducted on an intention-to-treat basis, based on the group to which women were randomized, irrespective of whether screening was completed. Of 12,483 eligible participants, 6233 women were randomized to screening, with treatment recommended in 898 (14.4%). No evidence of an effect or interaction was observed for the outcomes of any fracture or osteoporotic fracture. In the screening arm, 54 fewer hip fractures were observed than in the control arm (164 versus 218, 2.6% versus 3.5%), and commensurate with treatment being targeted to those at highest hip fracture risk, the effect on hip fracture increased with baseline FRAX hip fracture probability (p = 0.021 for interaction); for example, at the 10th percentile of baseline FRAX hip probability (2.6%), there was no evidence that hip fractures were reduced (hazard ratio [HR] = 0.93; 95% confidence interval [CI] 0.71 to 1.23), but at the 90th percentile (16.6%), there was a 33% reduction (HR = 0.67; 95% CI 0.53 to 0.84). Prior fracture and parental history of hip fracture positively influenced screening effectiveness on hip fracture risk. We conclude that women at high risk of hip fracture based on FRAX probability are responsive to appropriate osteoporosis management. © 2018 American Society for Bone and Mineral Research.

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“…[35][36][37][38][39][40][41][42] The remaining articles were from teams located in the USA (3), [43][44][45] UK (1), 46 and Denmark (1), 47 and all articles were published within the last 15 years. Two studies also interviewed provider participants; 44,46 for the purposes of this analysis, only patient data were included. All articles were appraised at moderate to high quality, ranging in scores on the CASP qualitative quality appraisal tool from 7 to 10.…”

Section: Resultsmentioning

confidence: 99%

Metasynthesis of Patient Attitudes Toward Bone Densitometry

et al. 2018

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Minimal knowledge exists of patient perceptions and experiences of DXA among those who are fracture naïve: Prior research has focused primarily on secondary fracture prevention contexts. Our metasynthesis reveals patients' significant reliance, given their limited risk appraisal and knowledge, upon primary care providers in decision-making. We urge colleagues to conduct qualitative research on DXA barriers among general primary care population in order to facilitate health care delivery systems better equipped to diagnose and treat patients before their first fracture.

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Acceptability of screening to prevent osteoporotic fractures: a qualitative study with older women

Abstract: Our findings suggest an effective and cost-effective screening programme to reduce osteoporotic fractures could be implemented in routine care and would be well received by women and GPs.

Cited by 15 publications

References 17 publications

Qualitative Insights from the Osteoporosis Research: A Narrative Review of the Literature

Qualitative Insights from the Osteoporosis Research: A Narrative Review of the Literature

Management of Patients With High Baseline Hip Fracture Risk by FRAX Reduces Hip Fractures—A Post Hoc Analysis of the SCOOP Study

Metasynthesis of Patient Attitudes Toward Bone Densitometry

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