高リスクの男性における骨粗鬆症スクリーニングのための遠隔骨保健サービス:クラスターランダム化臨床試験
Cathleen Colón-Emeric1,2, Richard Lee1,2, Kenneth W Lyles1,2
1Geriatrics Research Education and Clinical Center and Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health System, Durham, North Carolina.
JAMA internal medicine
|August 25, 2025
まとめ
骨折の危険因子を持つ高齢者の骨粗鬆症のスクリーニング,治療,遵守を大幅に改善しました. このモデルは患者と臨床医の高い受け入れを示し,多くの骨粗鬆症や骨粗鬆症の症例を特定しています.
科学分野:
- 高齢者医療
- 公衆衛生
- 臨床試験
背景:
- 男性における骨粗鬆症のスクリーニングには 確固たる証拠や 効果的なプライマリケアモデルが不足しています
- 骨粗鬆症のスクリーニングと骨折のリスクのある高齢者の治療の順守を改善する必要がある.
研究 の 目的:
- 骨粗鬆症のスクリーニング,治療開始,アデレンス,骨の密度に関する中心化された遠隔骨の健康サービス (BHS) の影響を評価する.
主な方法:
- 2つの退役軍人保健システムで39のプライマリケアチームを対象としたクラスターランダム化臨床試験.
- 骨折リスク要因が少なくとも1つあった 65歳から85歳までの男性退役軍人は含まれておらず,以前の骨折は含まれていなかった.
- 介入グループは,DXAスクリーニング,電子相談,看護師の管理を含むリモートBHSを受け,対照群は通常のケアとガイドラインを受けました.
主要な成果:
- 骨粗鬆症のスクリーニング率は,通常の治療と比較してBHS群 (49. 2%) で有意に高かった.
- 検診対象者の半数以上は骨粗鬆症または骨粗鬆症でした.
- BHSグループは,骨粗鬆症の治療開始率 (84. 4%),治療継続率 (91. 7%),および治療継続率 (平均657日) が高いことを示した.
- 24ヶ月でTスコアでBHSグループに好意的な傾向が見られた.
結論:
- 骨粗鬆症のスクリーニング,治療,リスクの高い高齢者の遵守を 効率的に改善します
- 骨折前の臨床的危険因子に基づくスクリーニングは,高い結果を出します.
- 骨折の減少を評価するには,様々な状況でのさらなる検証と,より長い追跡が必要である.
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