Marked Heterogeneity in Osteoporosis Treatment Preferences Found Among Patients

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In patients with osteoporosis, treatment preference varies but is not related to specific patient characteristics.

In patients with osteoporosis, treatment preference varies but is not related to specific patient characteristics, according to study results published in Osteoporosis International.

The results indicate that clinicians should involve patients more actively in treatment decision making in order to understand their preferences.

The study included data from a discrete choice experiment of patients with osteoporosis (N=188). The hypothetical treatment options were characterized by treatment efficacy, adverse events, and mode/frequency of administration. The researchers used a mixed logit model to measure heterogeneity and conducted subgroup analyses to identify potential effects of patient characteristics. Associations between patient characteristics, including medical and sociodemographic data, and identified latent classes were explored. Latent classes comprised patients who were classified by their reported preferences to a set of unobserved (latent) data, allowing for comparisons between subpopulations rather than individuals.

Most of the patients (78%) were women. Overall, 70% had osteoporosis and 49% reported the use of anti-osteoporosis medication. The results indicated that all treatment options were important to patients’ osteoporotic treatment decision. The researchers observed significant heterogeneity for most attributes.

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After performing subgroup analyses, the researchers found that patients with a previous fracture placed the highest value on efficacy, while patients with a fear of needles or aged >65 years preferred oral tablets. They also found that elderly patients disliked intravenous medication.

The researchers identified 3 latent classes. The majority of patients (65%) were placed into 1 of 3 classes. Of these, 2 classes preferred 6-month subcutaneous injection (86%) while class 3 preferred oral tablets (14%).

There were no significant associations between the profiles with regard to sociodemographic or clinical characteristics.

“[T]he importance of improving therapy adherence urges that patients should be offered a more active role in the choice of treatment, tailored to their preferences, fears, and believes, irrespective of their characteristics, or current treatment protocol,” the researchers wrote.

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Cornelissen D, Boonen A, Bours S, Evers S Dirksen C, Hiligsmann. Understanding patients’ preferences for osteoporosis treatment: the impact of patients’ characteristics on subgroups and latent classes [published online October 12, 2019]. Osteoporos Int. doi:10.1007/s00198-019-05154-9