Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fractures
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10362/21969 |
Resumo: | OBJECTIVE: To establish Portuguese recommendations regarding the indication to perform DXA and to initiate medication aimed at the prevention of fragility fractures. METHODS: A multidisciplinary panel, representing the full spectrum of medical specialties and patient associations devoted to osteoporosis, as well as national experts in this field and in health economics, was gathered to developed recommendations based on available evidence and expert consensus. Recently obtained data on the Portuguese epidemiologic, economic and quality-of-life aspects of fragility fractures were used to support decisions. RESULTS: 10 recommendations were developed covering the issues of whom to investigate with DXA and whom to treat with antifracture medications. Thresholds for assessment and intervention are based on the cost-effectiveness analysis of interventions at different thresholds of ten-year probability of osteoporotic fracture, calculated with the Portuguese version of FRAX® (FRAX®Port), and taking into account Portuguese epidemiologic and economic data. Limitations of FRAX® are highlighted and guidance for appropriate adjustment is provided, when possible. CONCLUSIONS: Cost-effectiveness thresholds for DXA examination and drug intervention aiming at fragility fracture prevention are now provided for the Portuguese population. These are practical, based on national epidemiological and economic data, evidence-based and supported by a wide scope multidisciplinary panel of experts and scientific societies. Implementation of these recommendations holds great promise in assuring the most effective use of health resources in the prevention of osteoporotic fractures in Portugal. |
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Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fracturesBONE-MINERAL DENSITYCLINICAL RISK-FACTORSASYMPTOMATIC PRIMARY HYPERPARATHYROIDISMOSTEOPOROSIS TREATMENT THRESHOLDSANDROGEN-DEPRIVATION THERAPYPOSTMENOPAUSAL WOMENINTERVENTION THRESHOLDSAROMATASE INHIBITORSOLDER WOMENFRAX TOOLOBJECTIVE: To establish Portuguese recommendations regarding the indication to perform DXA and to initiate medication aimed at the prevention of fragility fractures. METHODS: A multidisciplinary panel, representing the full spectrum of medical specialties and patient associations devoted to osteoporosis, as well as national experts in this field and in health economics, was gathered to developed recommendations based on available evidence and expert consensus. Recently obtained data on the Portuguese epidemiologic, economic and quality-of-life aspects of fragility fractures were used to support decisions. RESULTS: 10 recommendations were developed covering the issues of whom to investigate with DXA and whom to treat with antifracture medications. Thresholds for assessment and intervention are based on the cost-effectiveness analysis of interventions at different thresholds of ten-year probability of osteoporotic fracture, calculated with the Portuguese version of FRAX® (FRAX®Port), and taking into account Portuguese epidemiologic and economic data. Limitations of FRAX® are highlighted and guidance for appropriate adjustment is provided, when possible. CONCLUSIONS: Cost-effectiveness thresholds for DXA examination and drug intervention aiming at fragility fracture prevention are now provided for the Portuguese population. These are practical, based on national epidemiological and economic data, evidence-based and supported by a wide scope multidisciplinary panel of experts and scientific societies. Implementation of these recommendations holds great promise in assuring the most effective use of health resources in the prevention of osteoporotic fractures in Portugal.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Centro de Estudos de Doenças Crónicas (CEDOC)RUNMarques, AndréaMaria Rodrigues, AnaRomeu, José CarlosRuano, AfonsoBarbosa, Ana PaulaSimões, EugéniaÁguas, FernandaCanhão, HelenaAlves, José António Pereira DelgadoLucas, RaquelBranco, JaimeLaíns, JorgeMascarenhas, MárioSimões, SuseteTavares, VivianaLourenço, Oscarda Silva, José António Pereira2017-07-14T22:01:38Z2016-102016-10-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article18application/pdfhttp://hdl.handle.net/10362/21969eng0303-464XPURE: 2141479info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:09:08Zoai:run.unl.pt:10362/21969Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:27:04.220804Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fractures |
title |
Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fractures |
spellingShingle |
Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fractures Marques, Andréa BONE-MINERAL DENSITY CLINICAL RISK-FACTORS ASYMPTOMATIC PRIMARY HYPERPARATHYROIDISM OSTEOPOROSIS TREATMENT THRESHOLDS ANDROGEN-DEPRIVATION THERAPY POSTMENOPAUSAL WOMEN INTERVENTION THRESHOLDS AROMATASE INHIBITORS OLDER WOMEN FRAX TOOL |
title_short |
Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fractures |
title_full |
Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fractures |
title_fullStr |
Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fractures |
title_full_unstemmed |
Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fractures |
title_sort |
Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fractures |
author |
Marques, Andréa |
author_facet |
Marques, Andréa Maria Rodrigues, Ana Romeu, José Carlos Ruano, Afonso Barbosa, Ana Paula Simões, Eugénia Águas, Fernanda Canhão, Helena Alves, José António Pereira Delgado Lucas, Raquel Branco, Jaime Laíns, Jorge Mascarenhas, Mário Simões, Susete Tavares, Viviana Lourenço, Oscar da Silva, José António Pereira |
author_role |
author |
author2 |
Maria Rodrigues, Ana Romeu, José Carlos Ruano, Afonso Barbosa, Ana Paula Simões, Eugénia Águas, Fernanda Canhão, Helena Alves, José António Pereira Delgado Lucas, Raquel Branco, Jaime Laíns, Jorge Mascarenhas, Mário Simões, Susete Tavares, Viviana Lourenço, Oscar da Silva, José António Pereira |
author2_role |
author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Centro de Estudos de Doenças Crónicas (CEDOC) RUN |
dc.contributor.author.fl_str_mv |
Marques, Andréa Maria Rodrigues, Ana Romeu, José Carlos Ruano, Afonso Barbosa, Ana Paula Simões, Eugénia Águas, Fernanda Canhão, Helena Alves, José António Pereira Delgado Lucas, Raquel Branco, Jaime Laíns, Jorge Mascarenhas, Mário Simões, Susete Tavares, Viviana Lourenço, Oscar da Silva, José António Pereira |
dc.subject.por.fl_str_mv |
BONE-MINERAL DENSITY CLINICAL RISK-FACTORS ASYMPTOMATIC PRIMARY HYPERPARATHYROIDISM OSTEOPOROSIS TREATMENT THRESHOLDS ANDROGEN-DEPRIVATION THERAPY POSTMENOPAUSAL WOMEN INTERVENTION THRESHOLDS AROMATASE INHIBITORS OLDER WOMEN FRAX TOOL |
topic |
BONE-MINERAL DENSITY CLINICAL RISK-FACTORS ASYMPTOMATIC PRIMARY HYPERPARATHYROIDISM OSTEOPOROSIS TREATMENT THRESHOLDS ANDROGEN-DEPRIVATION THERAPY POSTMENOPAUSAL WOMEN INTERVENTION THRESHOLDS AROMATASE INHIBITORS OLDER WOMEN FRAX TOOL |
description |
OBJECTIVE: To establish Portuguese recommendations regarding the indication to perform DXA and to initiate medication aimed at the prevention of fragility fractures. METHODS: A multidisciplinary panel, representing the full spectrum of medical specialties and patient associations devoted to osteoporosis, as well as national experts in this field and in health economics, was gathered to developed recommendations based on available evidence and expert consensus. Recently obtained data on the Portuguese epidemiologic, economic and quality-of-life aspects of fragility fractures were used to support decisions. RESULTS: 10 recommendations were developed covering the issues of whom to investigate with DXA and whom to treat with antifracture medications. Thresholds for assessment and intervention are based on the cost-effectiveness analysis of interventions at different thresholds of ten-year probability of osteoporotic fracture, calculated with the Portuguese version of FRAX® (FRAX®Port), and taking into account Portuguese epidemiologic and economic data. Limitations of FRAX® are highlighted and guidance for appropriate adjustment is provided, when possible. CONCLUSIONS: Cost-effectiveness thresholds for DXA examination and drug intervention aiming at fragility fracture prevention are now provided for the Portuguese population. These are practical, based on national epidemiological and economic data, evidence-based and supported by a wide scope multidisciplinary panel of experts and scientific societies. Implementation of these recommendations holds great promise in assuring the most effective use of health resources in the prevention of osteoporotic fractures in Portugal. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-10 2016-10-01T00:00:00Z 2017-07-14T22:01:38Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10362/21969 |
url |
http://hdl.handle.net/10362/21969 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
0303-464X PURE: 2141479 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
18 application/pdf |
dc.source.none.fl_str_mv |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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