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绝经后女性骨质疏松症治疗的相关因素。

Factors related with osteoporosis treatment in postmenopausal women.

作者信息

Rossi Lia Mara Montagner, Copes Rafaela Martinez, Dal Osto Leo Canterle, Flores Clovis, Comim Fábio Vasconcellos, Premaor Melissa Orlandin

机构信息

Grupo de Pesquisa em Doenças Endócrino-Metabólicas Prevalentes, Departamento de Clínica Médica, Federal University of Santa Maria, Santa Maria, Brazil.

出版信息

Medicine (Baltimore). 2018 Jul;97(28):e11524. doi: 10.1097/MD.0000000000011524.

Abstract

Although fractures had high mortality and morbidity, many studies proved that fracture risk might be decreased by pharmacological therapy, although a low treatment adherence rate is observed. The aim of this study was to identify factors associated with osteoporosis treatment in postmenopausal women.A cross-sectional study was carried out from March to August 2013 at the primary care setting. Postmenopausal women were recruited. A standardized questionnaire was applied. Women who were using at least one of the following drugs at the moment of the survey were considered as current treatment: bisphosphonates, raloxifene, estrogen, calcitonin, teriparatide, or strontium ranelate. Women who had used any of the mentioned medications before the study were considered as past treatment.Of the 1025 women included in the study, 8% were on current treatment, 5.7% had past treatment, and 86.3% had not received treatment. Treated women (either current or past) had a higher rate of osteoarthritis, had more falls, had higher education level, presented a higher rate of private health insurance, and received more information about osteoporosis. They also had more dual-energy x-ray absorptiometry (DXA) scans and were more frequently diagnosed with osteoporosis by these DXA scans. The factors independently associated with treatment in the regression analysis were the DXA scan itself, the diagnosis of osteoporosis by DXA, and information about osteoporosis.Current and past treatments of osteoporosis were associated with DXA and information. These results suggest that some measures to inform women about osteoporosis and or even the popularization of DXA scans could improve the treatment.

摘要

尽管骨折具有较高的死亡率和发病率,但许多研究证明,药物治疗可能会降低骨折风险,尽管观察到治疗依从率较低。本研究的目的是确定绝经后女性骨质疏松症治疗的相关因素。

2013年3月至8月在初级保健机构进行了一项横断面研究。招募绝经后女性。应用标准化问卷。在调查时正在使用以下至少一种药物的女性被视为当前治疗:双膦酸盐、雷洛昔芬、雌激素、降钙素、特立帕肽或雷奈酸锶。在研究前曾使用过上述任何一种药物的女性被视为过去治疗。

在纳入研究的1025名女性中,8%正在接受当前治疗,5.7%有过过去治疗,86.3%未接受过治疗。接受治疗的女性(当前或过去)骨关节炎发生率更高,跌倒次数更多,教育水平更高,私人健康保险覆盖率更高,获得的骨质疏松症信息更多。她们也接受了更多的双能X线吸收法(DXA)扫描,并且通过这些DXA扫描更频繁地被诊断为骨质疏松症。回归分析中与治疗独立相关的因素是DXA扫描本身、DXA诊断的骨质疏松症以及骨质疏松症信息。

骨质疏松症的当前和过去治疗与DXA和信息相关。这些结果表明,一些向女性宣传骨质疏松症的措施甚至DXA扫描的普及可能会改善治疗。

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