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实施与评估BoneRx的影响:为开始雄激素剥夺治疗的前列腺癌男性提供的健康骨骼处方

Implementing and Evaluating the Impact of BoneRx: A Healthy Bone Prescription for Men with Prostate Cancer Initiating Androgen Deprivation Therapy.

作者信息

Jones Jennifer M, Tsang Derek S, Zheng Shiyu, Yeheskel Ariel, Catton Charles N, Cheung Angela M, Hamilton Robert, Alibhai Shabbir M H

机构信息

Cancer Rehabilitation and Survivorship Program, Department of Supportive Care, Princess Margaret Cancer Centre, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada.

Raditation Medicine Program, Princess Margaret Cancer Centre, 610 University Av., Toronto, ON M5G 2M9, Canada.

出版信息

J Clin Med. 2022 May 11;11(10):2703. doi: 10.3390/jcm11102703.

DOI:10.3390/jcm11102703
PMID:35628830
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9144215/
Abstract

Background: The initiation of Androgen Deprivation Therapy (ADT) results in rapid and profound hypogonadism, resulting in significant bone and muscle loss, increasing the risk for osteoporosis (OP), falls, and fractures. Despite this, there exist very low rates of guideline adherent care regarding bone health in this population. We developed and implemented a healthy bone prescription tool entitled BoneRx to facilitate the uptake of guideline-concordant bone health care into practice and increase patient awareness and promote the uptake of health bone behaviours (HBBs). Methods: We conducted a cross-sectional pre-BoneRx implementation (n = 143) vs. post-implementation (n = 149) cohort study to evaluate the impact on (i) bone health care, patient engagement in HBB, and patient knowledge and health beliefs regarding OP. Results: There was a significant difference pre- vs. post BoneRx implementation on receipt of baseline BMD (34.7% vs. 59.5%, p < 0.0001) and bone health counselling (32.4% vs. 59.9%, p < 0.0001). More participants in the post-BoneRx implementation cohort reported taking vitamin D supplements 57% vs. 81% (p < 0.001) and calcium supplements 39% vs. 61% (p < 0.001). Physical activity levels also significantly increased (p = 0.021). No differences were detected in OP knowledge or feelings of OP susceptibility, seriousness, or health motivation. Conclusion: BoneRx is a simple, cost-effective, and acceptable strategy that could improve the care of PCa survivors receiving ADT.

摘要

背景

雄激素剥夺疗法(ADT)的启动会导致迅速而严重的性腺功能减退,进而导致显著的骨质和肌肉流失,增加骨质疏松症(OP)、跌倒和骨折的风险。尽管如此,该人群中遵循骨健康指南进行治疗的比例非常低。我们开发并实施了一种名为BoneRx的健康骨骼处方工具,以促进将符合指南的骨健康护理纳入实践,并提高患者意识,促进健康骨骼行为(HBBs)的采用。方法:我们进行了一项横断面研究,比较了BoneRx实施前(n = 143)与实施后(n = 149)的队列,以评估对以下方面的影响:(i)骨健康护理、患者对HBB的参与度,以及患者关于OP的知识和健康信念。结果:在接受基线骨密度检测方面(34.7%对59.5%,p < 0.0001)以及骨健康咨询方面(32.4%对59.9%,p < 0.0001),BoneRx实施前后存在显著差异。在BoneRx实施后的队列中,更多参与者报告服用维生素D补充剂(57%对81%,p < 0.001)和钙补充剂(39%对61%,p < 0.001)。身体活动水平也显著提高(p = 0.021)。在OP知识或对OP易感性、严重性或健康动机的感受方面未检测到差异。结论:BoneRx是一种简单、经济有效且可接受的策略,可改善接受ADT的前列腺癌幸存者的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/829c/9144215/c5fe3226d941/jcm-11-02703-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/829c/9144215/018e147de13f/jcm-11-02703-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/829c/9144215/51dc24316f89/jcm-11-02703-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/829c/9144215/dcdfed4d3dfd/jcm-11-02703-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/829c/9144215/c5fe3226d941/jcm-11-02703-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/829c/9144215/018e147de13f/jcm-11-02703-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/829c/9144215/51dc24316f89/jcm-11-02703-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/829c/9144215/dcdfed4d3dfd/jcm-11-02703-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/829c/9144215/c5fe3226d941/jcm-11-02703-g004.jpg

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