Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O Box 616, 6200 MD, Maastricht, The Netherlands.
Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.
Osteoporos Int. 2024 Jan;35(1):69-79. doi: 10.1007/s00198-023-06906-4. Epub 2023 Sep 21.
This study describes the development of a decision aid (DA), aimed at supporting patients in their decision whether to start anti-osteoporosis medication. People with recent fractures or osteoporosis and health professionals were supportive of the DA initiative. An experimental study been started to assess (cost-)effectiveness of the DA.
At fracture liaison services (FLS), patients with a recent fracture ánd osteoporosis or a prevalent vertebral fracture are advised to start anti-osteoporosis medication (AOM). This study describes the development of a decision aid (DA) to support patients and healthcare providers (HCPs) in their decision about whether to start AOM.
The DA was developed according to International Patient Decision Aid Standards (IPDAS). A systematic procedure was chosen including scope, design, prototype development, and alpha testing. A previously developed DA for women with osteoporosis was used as a basis. Furthermore, input from literature searches, the Dutch guideline on management of osteoporosis, and from people with a fracture or osteoporosis was used. The updated DA was evaluated during alpha testing.
The DA facilitates the decision of patients whether to initiate AOM treatment and provides information on fractures and osteoporosis, general risk factors that increase the likelihood of a subsequent fracture, the role of lifestyle, personalized risk considerations of a subsequent fracture with and without AOM treatment, and AOM options and their characteristics in an option grid. Alpha testing with 15 patients revealed that patient preferences and needs were adequately presented, and several suggestions for improvement (e.g. adding more specific information, simplifying terminology, improving icon use) were accounted for. Participants from the alpha testing recommended use of the DA during outpatient visits.
Professionals and persons with osteoporosis were supportive of the proposed DA and its usability. The DA could help in a shared decision-making process between patients and HCPs.
本研究描述了一种决策辅助工具（DA）的开发，旨在支持患者决定是否开始抗骨质疏松药物治疗。最近发生骨折或患有骨质疏松症的患者和卫生专业人员对 DA 倡议表示支持。已开始进行一项实验研究，以评估 DA 的（成本）效果。
在骨折联络服务（FLS）处，建议最近发生骨折且患有骨质疏松症或存在椎体骨折的患者开始抗骨质疏松药物治疗（AOM）。本研究描述了一种决策辅助工具（DA）的开发，以支持患者和医疗保健提供者（HCP）在是否开始 AOM 方面做出决策。
根据国际患者决策辅助工具标准（IPDAS）开发了 DA。选择了一种系统的程序，包括范围、设计、原型开发和 alpha 测试。使用了先前为患有骨质疏松症的女性开发的 DA 作为基础。此外，还从文献搜索、荷兰骨质疏松症管理指南以及患有骨折或骨质疏松症的人那里获得了信息。在 alpha 测试期间评估了更新后的 DA。
DA 有助于患者决定是否开始 AOM 治疗，并提供有关骨折和骨质疏松症的信息，增加随后骨折可能性的一般风险因素，生活方式的作用，有无 AOM 治疗的情况下后续骨折的个性化风险考虑因素，以及 AOM 选项及其在选项网格中的特征。对 15 名患者进行的 alpha 测试表明，患者的偏好和需求得到了充分体现，并考虑了一些改进建议（例如添加更具体的信息、简化术语、改进图标使用）。来自 alpha 测试的参与者建议在门诊就诊期间使用 DA。
专业人员和骨质疏松症患者对拟议的 DA 及其可用性表示支持。DA 可以帮助患者和 HCP 之间进行共同决策过程。
