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3D骨模型改善骨质疏松症患者治疗起始情况:一项随机对照试验

3-D bone models to improve treatment initiation among patients with osteoporosis: A randomised controlled pilot trial.

作者信息

Stephens Melika H, Grey Andrew, Fernandez Justin, Kalluru Ramanamma, Faasse Kate, Horne Anne, Petrie Keith J

机构信息

a Department of Psychological Medicine , University of Auckland , Auckland , New Zealand.

b Department of Medicine , University of Auckland , Auckland , New Zealand.

出版信息

Psychol Health. 2016;31(4):487-97. doi: 10.1080/08870446.2015.1112389. Epub 2015 Nov 17.

Abstract

OBJECTIVE

To investigate the efficacy of 3-D printed bone models as a tool to facilitate initiation of bisphosphonate treatment among individuals who were newly diagnosed with osteoporosis.

DESIGN

Fifty eight participants with estimated fracture risk above that at which guidelines recommend pharmacological intervention were randomised to receive either a standard physician interview or an interview augmented by the presentation of 3-D bone models.

MAIN OUTCOME MEASURES

Participants' beliefs about osteoporosis and bisphosphonate treatment, initiation of bisphosphonate therapy assessed at two months using self-report and pharmacy dispensing data.

RESULTS

Individuals in the 3-D bone model intervention condition were more emotionally affected by osteoporosis immediately after the interview (p = .04) and reported a greater understanding of osteoporosis at follow-up (p = .04), than the control group. While a greater proportion of the intervention group initiated an oral bisphosphonate regimen (alendronate) (52%) in comparison with the control group (21%), the overall initiation of medication for osteoporosis, including infusion (zoledronate), did not differ significantly (intervention group 62%, control group 45%, p = .19).

CONCLUSION

The presentation of 3-D bone models during a medical consultation can modify cognitive and emotional representations relevant to treatment initiation among people with osteoporosis and might facilitate commencement of bisphosphonate treatment.

摘要

目的

探讨3D打印骨模型作为一种工具,在新诊断为骨质疏松症的个体中促进双膦酸盐治疗启动的疗效。

设计

58名估计骨折风险高于指南推荐进行药物干预阈值的参与者被随机分组,分别接受标准的医生访谈或通过展示3D骨模型增强的访谈。

主要观察指标

参与者对骨质疏松症和双膦酸盐治疗的信念,在两个月时使用自我报告和药房配药数据评估双膦酸盐治疗的启动情况。

结果

与对照组相比,3D骨模型干预组的个体在访谈后立即对骨质疏松症的情绪影响更大(p = 0.04),并且在随访时报告对骨质疏松症有更深入的理解(p = 0.04)。虽然干预组中开始口服双膦酸盐方案(阿仑膦酸盐)的比例(52%)高于对照组(21%),但包括静脉输注(唑来膦酸)在内的骨质疏松症药物总体启动情况无显著差异(干预组62%,对照组45%,p = 0.19)。

结论

在医疗咨询过程中展示3D骨模型可以改变与骨质疏松症患者治疗启动相关的认知和情感表现,并可能促进双膦酸盐治疗的开始。

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