Improving bone health in men with prostate cancer receiving androgen deprivation therapy: Results of a randomized phase 2 trial.

Autor: Alibhai SMH; Department of Medicine, University Health Network, Toronto, Ontario, Canada.; Department of Medicine, University of Toronto, Toronto, Ontario, Canada., Breunis H; Department of Medicine, University Health Network, Toronto, Ontario, Canada., Timilshina N; Department of Medicine, University Health Network, Toronto, Ontario, Canada., Hamidi MS; Department of Medicine, University Health Network, Toronto, Ontario, Canada., Cheung AM; Department of Medicine, University Health Network, Toronto, Ontario, Canada.; Department of Medicine, University of Toronto, Toronto, Ontario, Canada., Tomlinson GA; Department of Medicine, University Health Network, Toronto, Ontario, Canada., Manokumar T; Department of Medicine, University Health Network, Toronto, Ontario, Canada., Samadi O; Department of Medicine, University Health Network, Toronto, Ontario, Canada., Sandoval J; Department of Medicine, University Health Network, Toronto, Ontario, Canada., Durbano S; Department of Medicine, University Health Network, Toronto, Ontario, Canada., Warde P; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.; Radiation Medicine Program, University Health Network, Toronto, Ontario, Canada., Jones JM; Department of Psychosocial Oncology, University Health Network, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2018 Mar 15; Vol. 124 (6), pp. 1132-1140. Date of Electronic Publication: 2017 Dec 06.
DOI: 10.1002/cncr.31171
Abstrakt: Background: Strategies to improve bone health care in men receiving androgen deprivation therapy (ADT) are not consistently implemented. The authors conducted a phase 2 randomized controlled trial of 2 education-based models-of-care interventions to determine their feasibility and ability to improve bone health care.
Methods: A single-center parallel-group randomized controlled trial of men with prostate cancer who were receiving ADT was performed. Participants were randomized 1:1:1 to 1) a patient bone health pamphlet and brief recommendations for their family physician (BHP+FP); 2) a BHP and support from a bone health care coordinator (BHP+BHCC); or 3) usual care. The primary efficacy outcome was receipt of a bone mineral density (BMD) test within 6 months. Secondary efficacy outcomes included guideline-appropriate calcium and vitamin D use and bisphosphonate prescriptions for men at high fracture risk. Feasibility endpoints included recruitment, retention, satisfaction, contamination, and outcome capture. The main analysis used logistic regression with a 1-sided P of .10. The trial is registered at ClinicalTrials.gov (identifier NCT02043236).
Results: A total of 119 men were recruited. The BHP+BHCC strategy was associated with a greater percentage of men undergoing a BMD test compared with the usual-care group (78% vs 36%; P<.001). BMD ordering also was found to be increased with the BHP+FP strategy (58% vs 36%; P = .047). Both strategies were associated with higher percentages of patients using calcium and vitamin D, but only the BHP+FP arm was statistically significant (P = .039). No men were detected to be at high fracture risk. All but one feasibility endpoint was met.
Conclusions: Educational strategies to improve bone health care appear feasible and are associated with improved BMD ordering in men receiving ADT. Cancer 2018;124:1132-40. © 2017 American Cancer Society.
(© 2017 American Cancer Society.)
Databáze: MEDLINE
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