社区查以减少老年妇女的骨折 (SCOOP):一个随机对照试验
Lee Shepstone1, Elizabeth Lenaghan1, Cyrus Cooper2
1School of Medicine, University of East Anglia, Norwich, UK.
Lancet (London, England)
|December 20, 2017
概括
社区对老年妇女的骨质疏松骨折风险进行查是可行的,并有效减少骨折. 这种方法可以显著降低这一群体的部骨折发生率.
科学领域:
- 老年学
- 公共卫生
- 流行病学
背景情况:
- 骨质疏松症和相关骨折对老年人的健康造成重大负担.
- 目前英国的指导方针不建议进行常规骨折风险查.
- 有效的评估方法和药物存在, 但在预防策略中未得到充分利用.
研究的目的:
- 评估社区查干预措施减少老年妇女骨折的有效性.
- 确定是否可以在初级保健机构实施骨折风险的系统查.
主要方法:
- 这是一项双臂随机对照试验,涉及100家英国全科医院的12483名年龄在70-85岁的妇女.
- 使用骨折风险评估工具 (FRAX) 的查计划与常规护理的比较.
- 主要结论:5年内骨质疏松症相关骨折的发生率. 二次结果:部骨折,临床骨折,死亡率,焦虑和生活质量.
主要成果:
- 查并没有显著降低骨质疏松症相关或所有临床骨折的总体发病率.
- 然而,查干预显著降低了骨骨折的发生率 (HR 0. 72, p=0. 002).
- 在查组中,骨质疏松症药物的使用率较高 (15%与1年4%相比),高危人群的吸收率较高.
结论:
- 一个系统的,基于社区的骨折风险查计划对英国的老年妇女是可行的.
- 这种方案在减少部骨折方面表现出有效性,
- 这凸显了有针对性的干预措施在老龄化人口中减轻特定骨折风险的潜力.
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