Sharma Mitali, Beaudart Charlotte, Clark Patricia, Fujiwara Saeko, Adachi Jonathan D, Papaioannou Alexandra, Messina Osvaldo D, Morin Suzanne N, Kohlmeier Lynn, Nogues Xavier, Leckie Carolyn, Harvey Nicholas C, Kanis John A, Reginster Jean-Yves, Hiligsmann Mickael, Silverman Stuart L
The OMC Research Center, Beverly Hills, CA, USA.
Department of Health Services Research, CAPHRI Care & Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Osteoporos Int. 2025 Jan;36(1):71-80. doi: 10.1007/s00198-024-07264-5. Epub 2024 Oct 21.
This study aims to understand how osteoporosis medication acceptance varies across countries with differing guidance on treatment threshold and influence of clinical and demographic factors. A total of 79.2% accepted treatment at a fracture probability at or below the treatment threshold. Fracture history and age did not strongly impact acceptance, suggesting a need for improved fracture risk communication.
This part of the Improving Risk Communication in Osteoporosis (RICO) study aims to understand patients' willingness to initiate osteoporosis treatment given a hypothetical fracture probability-derived from the FRAX® Risk Assessment Tool-and how age, fracture history, and numeric literacy may influence this.
In 2022-2023, 332 postmenopausal women at risk of fracture were interviewed from nine countries to determine participants' Fracture Risk Decision Point (FRDP), the lowest probability of major osteoporotic fracture at which they would accept an osteoporosis medication. Participants' FRDP was evaluated given eight hypothetical 10-year FRAX scores.
In countries with FRAX-based treatment thresholds, over half of the participants per country reported an FRDP that was below the threshold. Collectively, 79.2% demonstrated FRDPs at or below their respective threshold. Age and fracture history did not have a strong influence on FRDP; however, those who demonstrated higher levels of numeric literacy reported a significantly higher median FRDP (10%) compared to those who showed lower levels (5%, p < 0.001).
Most patients were willing to accept an osteoporosis medication prescription at a hypothetical FRAX probability that was even lower than that of their nationally recommended treatment threshold. Literacy scores had a significant influence on FRDP whereas age and fracture history did not.
本研究旨在了解在治疗阈值指导不同以及临床和人口因素影响各异的情况下，各国对骨质疏松症药物的接受情况如何变化。共有79.2%的人在骨折概率等于或低于治疗阈值时接受治疗。骨折史和年龄对接受情况的影响不大，这表明需要改善骨折风险沟通。
骨质疏松症风险沟通改善（RICO）研究的这一部分旨在了解患者在给定源自FRAX®风险评估工具的假设骨折概率情况下启动骨质疏松症治疗的意愿，以及年龄、骨折史和数字素养如何影响这一意愿。
在2022年至2023年期间，对来自9个国家的332名有骨折风险的绝经后妇女进行了访谈，以确定参与者的骨折风险决策点（FRDP），即他们愿意接受骨质疏松症药物治疗的最低主要骨质疏松性骨折概率。根据八个假设的10年FRAX评分评估参与者的FRDP。
在以FRAX为基础的治疗阈值的国家中，每个国家超过一半的参与者报告的FRDP低于阈值。总体而言，79.2%的人表现出的FRDP等于或低于各自的阈值。年龄和骨折史对FRDP没有强烈影响；然而，与数字素养水平较低的人（5%，p < 0.001）相比，数字素养水平较高的人报告的中位数FRDP显著更高（10%）。
大多数患者愿意在假设的FRAX概率下接受骨质疏松症药物处方，该概率甚至低于其国家推荐的治疗阈值。素养得分对FRDP有显著影响，而年龄和骨折史则没有。
