Women’s Values and Preferences Regarding Osteoporosis Treatments: A Systematic Review

Author:

Barrionuevo Patricia1,Gionfriddo Michael R23,Castaneda-Guarderas Ana2,Zeballos-Palacios Claudia2,Bora Pavithra14,Mohammed Khaled1,Benkhadra Khalid15,Sarigianni Maria1,Murad Mohammad Hassan1ORCID

Affiliation:

1. Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota

2. Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota

3. Center for Pharmacy Innovation and Outcomes, Geisinger, Danville, Pennsylvania

4. Memorial Hermann Rehabilitation and Research, Houston, Texas

5. Department of Internal Medicine, School of Medicine, Wayne State University, Detroit, Michigan

Abstract

Abstract Background Several treatments are available to reduce the risk of fragility fractures associated with osteoporosis. The choice of treatment requires knowledge of patients’ values and preferences. The aim of the present study was to summarize what is known about the values and preferences relevant to the management of osteoporosis in women. Methods We conducted a comprehensive search of several databases for studies reported in any language that had included women who had already started or were about to start any pharmacological therapy for osteoporosis. Pairs of reviewers independently selected the studies and extracted the data. The results were synthesized narratively. Results We included 26 studies reporting on 15,348 women (mean age, 66 years). The women considered the effectiveness and adverse events equally, followed by the convenience of taking the drug and its effect on daily routine (less frequent dosing was preferred, the oral route was preferred, and the injectable route was preferred over oral if given less frequently). The treatment cost and duration were less important factors for decision making. Fear of breast cancer and fear of resuming uterine bleeding were common reasons for not choosing estrogen therapy. Calcium and vitamin D were viewed as safe and natural. Across the studies, the preferences were not affected by age, previous drug exposure, or employment status. Conclusions Women starting osteoporosis medications value effectiveness and side effects equally and prefer medications given less frequently. Injectable drugs appear acceptable if given less frequently. More research on patient values and preferences is needed to guide decision making in osteoporosis.

Funder

National Center for Advancing Translational Science

National Institutes of Health

Endocrine Society

Publisher

The Endocrine Society

Subject

Biochemistry, medical,Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

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