Factors associated with the contemplative stage of readiness to initiate osteoporosis treatment.

Autor: Adami G; University of Alabama at Birmingham, Birmingham, AL, 35233, USA.; Rheumatology Unit, University of Verona, Verona, Italy., Saag KG; University of Alabama at Birmingham, Birmingham, AL, 35233, USA., Mudano AS; University of Alabama at Birmingham, Birmingham, AL, 35233, USA., Rahn EJ; University of Alabama at Birmingham, Birmingham, AL, 35233, USA., Wright NC; University of Alabama at Birmingham, Birmingham, AL, 35233, USA., Outman RC; University of Alabama at Birmingham, Birmingham, AL, 35233, USA., Greenspan SL; University of Pittsburgh, Pittsburgh, PA, 15213, USA., LaCroix AZ; Group Health Cooperative, Seattle, WA, 98112, USA.; University of California San Diego, La Jolla, CA, 92093, USA., Nieves JW; Helen Hayes Hospital, West Haverstraw, NY, 10993, USA., Silverman SL; Cedars-Sinai Medical Center, Los Angeles, CA, 30211, USA., Siris ES; Columbia University Medical Center, New York, NY, 10032, USA., Watts NB; Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, 45236, USA., Miller MJ; Texas A&M University, College Station, TX, 77843, USA.; Kaiser Permanente, Rockville, MD, 20852, USA., Ladores S; University of Alabama at Birmingham, Birmingham, AL, 35233, USA., Curtis JR; University of Alabama at Birmingham, Birmingham, AL, 35233, USA., Danila MI; University of Alabama at Birmingham, Birmingham, AL, 35233, USA. mdanila@uabmc.edu.
Jazyk: angličtina
Zdroj: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA [Osteoporos Int] 2020 Jul; Vol. 31 (7), pp. 1283-1290. Date of Electronic Publication: 2020 Feb 04.
DOI: 10.1007/s00198-020-05312-4
Abstrakt: We investigated the factors associated with readiness for initiating osteoporosis treatment in women at high risk of fracture. We found that women in the contemplative stage were more likely to report previously being told having osteoporosis or osteopenia, acknowledge concern about osteoporosis, and disclose prior osteoporosis treatment.
Introduction: Understanding factors associated with reaching the contemplative stage of readiness to initiate osteoporosis treatment may inform the design of behavioral interventions to improve osteoporosis treatment uptake in women at high risk for fracture.
Methods: We measured readiness to initiate osteoporosis treatment using a modified form of the Weinstein Precaution Adoption Process Model (PAPM) among 2684 women at high risk of fracture from the Activating Patients at Risk for OsteoPOroSis (APROPOS) clinical trial. Pre-contemplative participants were those who self-classified in the unaware and unengaged stages of PAPM (stages 1 and 2). Contemplative participants were those in the undecided, decided not to act, or decided to act stages of PAPM (stages 3, 4, and 5). Using multivariable logistic regression, we evaluated participant characteristics associated with levels of readiness to initiate osteoporosis treatment.
Results: Overall, 24% (N = 412) self-classified in the contemplative stage of readiness to initiate osteoporosis treatment. After adjusting for age, race, education, health literacy, and major osteoporotic fracture in the past 12 months, contemplative women were more likely to report previously being told they had osteoporosis or osteopenia (adjusted odds ratio [aOR] (95% CI) 11.8 (7.8-17.9) and 3.8 (2.5-5.6), respectively), acknowledge concern about osteoporosis (aOR 3.5 (2.5-4.9)), and disclose prior osteoporosis treatment (aOR 4.5 (3.3-6.3)) than women who self-classified as pre-contemplative.
Conclusions: For women at high risk for future fractures, ensuring women's recognition of their diagnosis of osteoporosis/osteopenia and addressing their concerns about osteoporosis are critical components to consider when attempting to influence stage of behavior transitions in osteoporosis treatment.
Databáze: MEDLINE
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