Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fractures

Andréa Marques, A M Rodrigues, José Carlos Romeu, Afonso Ruano, Ana Paula Barbosa, Eugénia Simões, Fernanda Águas, Helena Canhão, José António Pereira Delgado Alves, Raquel Lucas, Jaime C. Branco, Jorge Laíns, Mário Mascarenhas, Susete Simões, Viviana Tavares, Oscar Lourenço, José António Pereira da Silva

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
11 Downloads (Pure)

Abstract

OBJECTIVE: To establish Portuguese recommendations regarding the indication to perform DXA and to initiate medication aimed at the prevention of fragility fractures.

METHODS: A multidisciplinary panel, representing the full spectrum of medical specialties and patient associations devoted to osteoporosis, as well as national experts in this field and in health economics, was gathered to developed recommendations based on available evidence and expert consensus. Recently obtained data on the Portuguese epidemiologic, economic and quality-of-life aspects of fragility fractures were used to support decisions.

RESULTS: 10 recommendations were developed covering the issues of whom to investigate with DXA and whom to treat with antifracture medications. Thresholds for assessment and intervention are based on the cost-effectiveness analysis of interventions at different thresholds of ten-year probability of osteoporotic fracture, calculated with the Portuguese version of FRAX® (FRAX®Port), and taking into account Portuguese epidemiologic and economic data. Limitations of FRAX® are highlighted and guidance for appropriate adjustment is provided, when possible.

CONCLUSIONS: Cost-effectiveness thresholds for DXA examination and drug intervention aiming at fragility fracture prevention are now provided for the Portuguese population. These are practical, based on national epidemiological and economic data, evidence-based and supported by a wide scope multidisciplinary panel of experts and scientific societies. Implementation of these recommendations holds great promise in assuring the most effective use of health resources in the prevention of osteoporotic fractures in Portugal.

Original languageEnglish
Pages (from-to)305-321
Number of pages18
JournalActa reumatologica portuguesa
Volume41
Issue number4
Publication statusPublished - Oct 2016

Keywords

  • BONE-MINERAL DENSITY
  • CLINICAL RISK-FACTORS
  • ASYMPTOMATIC PRIMARY HYPERPARATHYROIDISM
  • OSTEOPOROSIS TREATMENT THRESHOLDS
  • ANDROGEN-DEPRIVATION THERAPY
  • POSTMENOPAUSAL WOMEN
  • INTERVENTION THRESHOLDS
  • AROMATASE INHIBITORS
  • OLDER WOMEN
  • FRAX TOOL

Fingerprint Dive into the research topics of 'Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fractures'. Together they form a unique fingerprint.

Cite this